PREVALENCE AND TIME TO CATARACT DEVELOPMENT IN CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS

PV167 / #832 Poster Topic: AS18 - Pediatric SLE Background/Purpose Cataracts are significant ocular complications in childhood-onset systemic lupus erythematosus (cSLE). This study aims to evaluate the prevalence, time to cataract development, and describe demographic and clinical features in a cohort of cSLE patients. Methods We conducted a retrospective analysis of patients who were followed for cSLE at a tertiary center Lupus clinic from 1992 to 2023. All patients had prospectively collected data and follow-up until the age of 18 years. Demographic and clinical characteristics, including sex, self-reported ethnicity, age at SLE diagnosis, disease duration, and SLE-related manifestations, were compared between patients with and without cataracts. Cataracts were diagnosed by ophthalmologists or optometrists and documented in lupus clinical chart as part of the Systemic Lupus Erythematosus Collaborative Clinics Damage Index (SLICC-DI). We completed survival analysis of time from SLE diagnosis to first cataract and conducted t-tests to compare features of patients with and without cataracts ( P < 0.05). Results Among the 482 cSLE patients included, 83% were female with a mean age at diagnosis of 13.1 ± 3.1 years and a mean follow-up time of 4.5 ± 3.0 years. The cohort was predominantly of European (28%) and East Asian (25%) ancestries, followed by South Asian (18%), American/Admixed (17%), and African (12%) ancestries (Table 1). The most common SLE-related manifestation was lupus nephritis, observed in 42% of patients, followed by arthritis (29%), serositis (16%), and neuropsychiatric systemic lupus erythematosus (NPSLE) (9%). A total of 43 (9%) patients developed cataracts. The majority of patients with cataracts were female (72%), with a longer mean disease duration (5.7 ± 2.8 years) compared to the non-cataract group (4.4 ± 3.0 years), and a younger mean age of SLE diagnosis (11.8 ± 2.9 years) than those without (13.3 ± 3.1 years). Patients with cataracts were more likely to have lupus nephritis (67% vs 40%, P = 0.001). When we examined time from SLE diagnosis to first cataract, 35/43 (81%) developed cataracts within 5 years of SLE diagnosis (Figure 1). Table 1. Clinical and demographic cohort features (n = 482) Figure 1. Conclusions In a multiethnic cohort of children and adolescents with cSLE, we observed that 9% developed cataracts within a mean of 4.2 years of follow-up. We also observed a higher prevalence of cataracts among those with younger age of SLE diagnosis, longer disease duration and lupus nephritis. Our next steps will include investigating the relative contributions of genetics and glucocorticosteroid exposure to cataract risk.