Title : Gender influences on uveitis etiology: Insights from a meta-analysis and systematic review
Abstract:
Purpose: To evaluate gender-specific differences in the etiology of uveitis through a comprehensive meta-analysis and systematic review, thereby illuminating how sex-based factors may influence disease prevalence, associated conditions, and potential underlying mechanisms.
Methods: the systemic and meta-analysis review conducted following the PRISMA guidelines searching through databases, like PubMed/MEDLINE, Scopus, Central, Web of Science and Google Scholar from January 2014 to January 2024. Our focus was on studies that differentiate between uveitis etiology based on gender. Risk ratios (RR) and 95% confidence intervals (CIs) were estimated using a Mantel-Haenszel random-effects model; heterogeneity was assessed via I². Study quality and risk of bias were evaluated using the Newcastle–Ottawa Scale and JBI Critical Appraisal Checklists.
Results: Our analysis revealed pronounced gender-related differences in uveitis etiologies. Females demonstrated a significantly higher risk of uveitis associated with autoimmune conditions, including Systemic Lupus Erythematosus (RR=2.25, p<0.0154), Multiple Sclerosis (RR=2.12, p<0.0015), Sarcoidosis (RR=1.97, p<0.0001), Rheumatoid Arthritis (RR=1.94, p<0.0110), and Juvenile Idiopathic Arthritis (RR=1.87, p<0.0005). Females also showed elevated risk for Vogt-Koyanagi-Harada disease (RR=1.32, p<0.0025) and Toxoplasmosis (RR=1.29, p<0.0458). In contrast, males had increased risk for uveitis linked to conditions such as Diabetes Mellitus (RR=0.29, p<0.0015), Eales Disease (RR=0.30, p<0.0006), Sympathetic Ophthalmia (RR=0.52, p<0.0063), Behçet's Disease (RR=0.56, p<0.0001), and Ankylosing Spondylitis (RR=0.57, p<0.0001).
Conclusions: This meta-analysis highlights significant gender differences in uveitis etiologies, with females more susceptible to autoimmune-associated uveitis and males more prone to uveitis linked to certain systemic conditions. These findings suggest that hormonal, genetic, and immunologic factors may drive sex-based disparities in disease pathophysiology. Recognizing these differences can guide targeted diagnostic approaches, optimize treatment strategies, and ultimately improve patient outcomes.
