Background/Purpose: Childhood uveitis can lead to poor
visual outcomes. Our data from single center studies suggests that non-Hispanic
African American children (NHB) with non-inflammatory uveitis have increased ocular
complications, and that African American race is a predictor of vision loss and
blindness.  Our aim is to characterize the epidemiology and clinical course of
non-Hispanic White (NHW) and NHB children with idiopathic uveitis in the CARRA
Registry.

Methods: There were 65 NHW and 11 NHB children
with idiopathic uveitis enrolled in the CARRA Registry.  Demographic and uveitis-related
data were collected from time of diagnosis to enrollment.   We compared
clinical characteristics of NHB and NHW children using 2 sample t-tests and chi-square
tests. Logistic regression was used to model risk factors for vision loss.

Results: The 11 (14.5%) NHB children had a mean
age of uveitis onset of 8.4 ± 3.0 years, 6 (55%) were female, and 3 (30%) were ANA
positive (Table 1).  Uveitis was primarily anterior in location (73%) and bilateral
(82%). Ocular complications were common (64%): cataracts (36%), increased
intraocular pressure (27%), posterior synechiae (27%) and keratic precipitates
(27%).  Uncorrected abnormal or blind vision was reported in the right eye in
86%, and in 71% in the left eye. 

Comparing NHW and NHB children (Table 1),
there were no significant differences in gender, smoking exposure, ANA
positivity, age of uveitis onset, location of uveitis, laterality, or presence
and type of ocular complications.  There were also no differences in insurance
status, age at first rheumatology visit, or time to first rheumatology visit
from disease onset. Medication use was similar except for increased use of oral
methotrexate in NHW (p=0.003).   There was a trend towards increased vision
loss or blindness in NHB children overall, but this was only statistically
significant in the right eye for uncorrected vision (85.7% vs. 36.4%, p =
0.034).  This may be secondary to our sample size or to one eye being most
affected. On logistic regression analysis, NHB race was a significant predictor
of vision loss in the right eye (OR = 10.5, (95% CI 1.16-95.11).  This was not
significant in the left eye (OR = 3.61, (95% CI 0.63 – 20.71).

Conclusion: In the CARRA registry, 14% of children
with idiopathic uveitis were NHB.  The odds of developing vision loss were 10.5
times greater in NHB children compared to NHW.  Although the numbers of NHB
children in this registry are small, these results support our previous
findings of racial
differences in the visual outcomes of children with uveitis. 
This highlights the need for further exploration of the impact of race in a
racially diverse cohort.

Table 1.
Comparison of Non-Hispanic White and Black Children with Idiopathic Uveitis