Sex-based Differences in Patients with Uveitis Notes Disease Predispositions

Women were five times more likely to develop MEWDS than men in this analysis comprising over five thousand patients. Photo: Rami Aboumourad, OD. Click image to enlarge. Uveitis is a major global cause of vision loss, with diverse causes including infections, autoimmune conditions and drug reactions. Its pathogenesis involves genetic, immune and infectious factors. A recent study published in American Journal of Ophthalmology helped determine sex-related patterns of uveitic entities and uveitic complications. Women more often developed autoimmune and inflammatory uveitis, such as Vogt-Koyanagi-Harada syndrome and birdshot chorioretinopathy. Cataracts were significantly more common in women, and this remained significant after adjusting for age at presentation, anatomical location and bilaterality. Cystoid macular edema and epiretinal membrane were also more frequent in women, whereas retinal detachment occurred more often in men.The researchers identified 5,703 from the Auckland Inflammatory Eye Disease Registry of New Zealand over 14 years and from Moorfields Eye Hospital of London over two years. In this cohort, 50.3% of participants were women and 49.6% were men. Male patients presented at a significantly younger age than women (42.2 vs 45.0).Significant sex-based differences were observed in the prevalence of specific uveitic conditions. Women were more likely to develop multifocal choroiditis (female:male ratio 1.82:1), Vogt-Koyanagi-Harada syndrome (female:male ratio 2.14:1), birdshot chorioretinopathy (female:male ratio 2.80:1), punctate inner choroidopathy (female:male ratio 6.57:1), drug-induced uveitis (female:male ratio 2.83:1), Crohn’s disease (female:male ratio 3.71:1) and multiple evanescent white dot syndrome (female:male ratio 5.00:1). In contrast, men were more likely to develop acute posterior multifocal placoid pigment epitheliopathy (female:male ratio 0.364:1), sympathetic ophthalmia (female:male ratio 0.353:1) and syphilis (female:male ratio 0.404:1).Vision loss (≤20/50) occurred in 20.4% of participants and was not significantly more common in women (21.4% vs 19.4%). However, bilateral vision loss occurred in 4.2% of patients and was significantly more common in women (4.9% vs 3.5%). This may reflect differences in disease type, with females more likely to have bilateral or systemic autoimmune uveitis such as birdshot chorioretinopathy and Vogt-Koyanagi-Harada, which carries a greater risk of bilateral involvement.“Sex appears to be a key factor influencing the underlying etiology and clinical course of uveitis,” the study authors wrote in their paper. “These findings underscore the importance of considering sex as a biological variable in the diagnosis, monitoring and management of uveitis.”Click here for the journal source. Samalia PD, Sims JL, Tomkins-Netzer O, et al. Sex-related effects on the clinical presentation of uveitis. October 25, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.