Incidence, Prevalence, and Clinical Associations of Non-Infectious Pediatric Uveitis in the United States: A TriNetX Database Study.

Abstract

To characterize the incidence, prevalence, demographics, anatomic subtypes, ocular complications, associated systemic diseases, and immunosuppressive treatment patterns of non-infectious pediatric uveitis in the United States using the TriNetX database. Retrospective incidence and prevalence study. Patients aged 17 years or younger with uveitis in the TriNetX US Collaborative Network between 2016 and 2025, stratified into anterior, intermediate, posterior, and panuveitis subtypes according to the Standardization of Uveitis Nomenclature classification. Demographic characteristics, ocular complications, associated systemic inflammatory diseases, and systemic immunosuppressive medications were identified using International Classification of Diseases, Tenth Revision, Clinical Modification, RxNorm, and Healthcare Common Procedure Coding System codes. Incidence and prevalence were calculated per 100,000 persons, annually and cumulatively, overall and by subtype. Proportions are reported with 95% confidence intervals (CIs) constructed using Wilson score intervals. Annual and cumulative incidence and prevalence of pediatric uveitis and its subtypes, demographic distribution, rates of ocular complications, associated systemic diseases, and immunosuppressive medication use. Of 30,729,490 children, 30,533 (0.10%) had uveitis. Median age was 11 years (interquartile range, 8 years); 16,671 (54.6%; 95% CI, 54.0-55.2) were male. Anterior uveitis was the most common subtype (22,481; 73.6%). From 2016 to 2025, annual incidence rose from 22 to 33 per 100,000 persons and prevalence from 106 to 226 per 100,000 persons. Glaucoma (2,509; 8.8%; 95% CI, 8.5-9.1) and cataract (1,962; 6.9%; 95% CI, 6.6-7.2) were the most common ocular complications; posterior uveitis had the highest rate of blindness and low vision (397; 13.4%; 95% CI, 12.2-14.6). Prednisone (3,979; 13.6%) and methotrexate (3,854; 13.1%) were most frequently prescribed, and antimetabolites were the most common class (4,568; 15.6%). Juvenile idiopathic arthritis (3,038; 10.4%) and tubulointerstitial nephritis and uveitis (450; 1.5%) were the most frequent discrete systemic associations. The incidence and prevalence of pediatric uveitis increased over the past decade. Anterior uveitis predominated, whereas ocular morbidity and treatment intensity concentrated in intermediate uveitis and vision loss in posterior uveitis. Juvenile idiopathic arthritis and tubulointerstitial nephritis and uveitis were frequent associations. Prospective studies should determine whether rising rates reflect a true increase in disease or improved detection.