Risk Factors for Visual Impairment and Blindness Due to Non-Infectious Uveitis in Colombia: COL-UVEA Report 3

BACKGROUND: Non-infectious uveitis (NIU) is a significant cause of visual impairment and blindness, especially in low- and middle-income countries. Delayed diagnosis, limited access to specialized care, and frequent ocular complications worsen outcomes. This study aimed to identify factors associated with any grade of visual impairment (VI) and blindness in NIU patients from a South American country. METHODS: Multicenter cross-sectional study including NIU patients from seven referral centers in Colombia (2010-2022). Evaluations included best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, and fundus examination. Non-infectious uveitis was classified according to the Standardization of Uveitis Nomenclature-endorsed criteria. Risk factors for VI (BCVA > 0.4 LogMAR) and blindness (BCVA > 1.0 LogMAR) were assessed using multivariate regression. RESULTS: A total of 1716 patients were included (60.4% female). Unilateral involvement (53.8%), acute onset (40.8%), and non-granulomatous inflammation (89.0%) were common. The most frequent complications were cataracts (23.7%), macular edema (9.5%), and glaucoma (9.4%). VI was observed in 59.0%, and blindness in 30.0%. Panuveitis was associated with an increased risk of VI (OR = 2.09; 95% CI 1.40-3.19) and blindness (OR = 3.67; 95% CI 2.46-5.47). Granulomatous inflammation was also linked to VI (OR = 1.54; 95% CI 1.10-2.19), and ocular complications were strongly associated with blindness (OR = 2.09; 95% CI 1.66-2.64). CONCLUSION: Panuveitis, granulomatous inflammation, and ocular complications significantly increase the risk of poor visual outcomes. These patients require closer monitoring and early immunosuppressive treatment.