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TOPLINE:

Children and adolescents with noninfectious uveitis had an elevated risk of developing immune-mediated inflammatory diseases (IMIDs) compared with the general pediatric population.

METHODOLOGY:

• Researchers analyzed health insurance claims data from Korea, focusing on children and adolescents younger than 20 years with newly diagnosed uveitis between 2011 and 2022.
• A total of 27,656 patients (mean age, 12.6 years; 58.3% male) with incident noninfectious uveitis and no prior diagnosis of IMID or immunosuppressant use were included, with a mean follow-up duration of 6 years.
• Patients were identified as having uveitis if they had at least three outpatient visits or one inpatient admission with uveitis diagnostic codes, along with a prescription for ocular or systemic corticosteroids.
• The analysis focused on 13 predefined IMIDs — juvenile idiopathic arthritis, ankylosing spondylitis, tubulointerstitial nephritis, Behçet disease, Kawasaki disease, sarcoidosis, systemic lupus erythematosus, multiple sclerosis, psoriasis, psoriatic arthritis, antiphospholipid syndrome, inflammatory bowel disease, and reactive arthritis.
• The primary outcomes were the estimated 5-year cumulative incidence of a composite of 13 predefined IMIDs and standardized incidence ratios (SIRs) compared with the general pediatric population.

TAKEAWAY:

• The overall 5-year cumulative incidence of IMIDs among pediatric patients with uveitis was 8.52% (95% CI, 8.16%-8.87%), with female patients showing a higher incidence of 10.03% (95% CI, 9.43%-10.63%) and male patients showing an incidence of 7.45% (95% CI, 7.01%-7.88%).
• Pediatric patients with uveitis demonstrated an elevated risk for IMIDs (SIR, 6.78; 95% CI, 6.54-7.02), with female patients showing a higher risk (SIR, 7.81; 95% CI, 7.43-8.21) than male patients (SIR, 5.99; 95% CI, 5.69-6.29). Patients aged 10-19 years exhibited an increased risk for IMIDs (SIR, 10.02; 95% CI, 9.64-10.42) compared with those aged 0-9 years (SIR, 2.78; 95% CI, 2.56-3.02).
• Among individual IMIDs, the SIR was highest for sarcoidosis (SIR, 444.48; 95% CI, 357.97-551.89), followed by ankylosing spondylitis (SIR, 68.94; 95% CI, 64.45-73.73), Behçet disease (SIR, 66.29; 95% CI, 57.81-76.02), and systemic lupus erythematosus (SIR, 30.69; 95% CI, 27.05-34.82).
• The cumulative incidence of immunosuppressant use was higher in secondary and tertiary care settings than in primary care settings (8.42%; 95% CI, 7.67%-9.16% vs 0.67%; 95% CI, 0.55%-0.79%).

IN PRACTICE:

“Because pediatric uveitis may be a sentinel manifestation of systemic disease, these results supported targeted surveillance and timely intervention to reduce long-term morbidity,” the authors of the study wrote.

SOURCE:

The study was led by Jay Jiyong Kwak, MD, Severance Hospital, Institute of Vision Research, Yonsei University, Seoul, and Seung Won Lee, MD, PhD, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea. It was published online on May 15, 2026, in JAMA Network Open.

LIMITATIONS:

The study utilized data from a single country with a relatively homogeneous Asian population, which may limit the generalizability of the findings. Nonanterior uveitis could not be further classified into intermediate, posterior, or panuveitis categories because the claims database uses the Korean Standard Classification of Diseases, which lacks detailed coding. The definition of uveitis required the use of corticosteroids, which may have led to the exclusion of mild cases that were managed without steroids.

DISCLOSURES:

The study received support from the National Research Foundation of Korea grant funded by the Korean government, with additional funding from the Korea Health Technology Research and Development Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.