An evaluation of baseline risk factors predicting severity in juvenile idiopathic arthritis associated uveitis and other chronic anterior uveitis in early childhood

Edelsten, Clive; Lee, Vickie; Bentley, Christopher; Kanski, Jack J.; Graham, Elizabeth

doi:10.1136/bjo.86.1.51

Cited by 212 publications

(171 citation statements)

References 24 publications

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“…Several factors have been identified which are associated with a more severe course of uveitis and development of complications [81][82][83]. These risk factors for poor prognosis include: male gender; young age at onset of uveitis; short duration between onset of arthritis and development of uveitis; and presence of synechiae at first diagnosis of uveitis.…”

Section: Prognosismentioning

confidence: 99%

Juvenile idiopathic arthritis-associated uveitis

Sen

Ramanan

2017

Best Practice & Research Clinical Rheumatology

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Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, with JIA-associated uveitis its most common extra-articular manifestation. JIA-associated uveitis is a potentially sight-threatening condition and thus carries a considerable risk of morbidity. The aetiology of the condition is autoimmune in nature with the predominant involvement of CD4 + T cells. However, the underlying pathogenic mechanisms remain unclear, particularly regarding interplay between genetic and environmental factors. JIA-associated uveitis comes in several forms, but the most common presentation is of the chronic anterior uveitis type. This condition is usually asymptomatic and thus screening for JIA-associated uveitis in at-risk patients is paramount. Early detection and treatment aims to stop inflammation and prevent the development of complications leading to visual loss, which can occur due to both active disease and burden of disease treatment. Visually disabling complications of JIA-associated uveitis include cataracts, glaucoma, band keratopathy and macular oedema. There is a growing body of evidence for the early introduction of systemic immunosuppressive therapies in order to reduce topical and systemic glucocorticoid use. This includes more traditional treatments, such as methotrexate, as well as newer biological therapies. This review highlights the epidemiology of JIA-associated uveitis, the underlying pathogenesis and how affected patients may present. The current guidelines and criteria for screening, diagnosis and monitoring are discussed along with approaches to management.

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Section: Prognosismentioning

confidence: 99%

Juvenile idiopathic arthritis-associated uveitis

Sen

Ramanan

2017

Best Practice & Research Clinical Rheumatology

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“…5 Complications develop frequently, at rates of 25-50% in patients with JIA-associated uveitis. [5][6][7] As the number of complications generally increases during the course of chronic disease, it is essential that inflammatory inactivity is achieved. A step-by-step antiinflammatory treatment approach is generally suggested, beginning with topical and possibly systemic corticosteroids.…”

Section: Introductionmentioning

confidence: 99%

Limited value of cyclosporine A for the treatment of patients with uveitis associated with juvenile idiopathic arthritis

Tappeiner

Roesel

Heinz

et al. 2008

Eye

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“…The cause and pathology of JIA are mostly unknown, and the hereditary portion is difficult, making complete differentiation among various subtypes complex. and 80% present of ANA [19].…”

Section: Juvenile Idiopathic Arthritismentioning

confidence: 99%

Ocular Manifestations of Pediatric Systemic Disease

Lim

2016

Hanyang Med Rev

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An ocular manifestation of a systemic disease is an ocular condition that directly or indirectly results from a pathologic process from another part of the body. Ocular manifestations can occur in various systemic diseases in pediatrics. However, ocular manifestations are difficult to recognize especially in pediatric diseases because most clinicians ignore ocular involvement of systemic diseases. Ocular manifestations can be the first findings of systemic disease in some pediatric disease, and numerous ocular manifestations can be associated with amblyopia, which is a disorder of sight. Therefore we must be able to recognize the ocular manifestations for diagnosis and management of pediatric systemic diseases.Although we cannot deal with ocular manifestations of all pediatric systemic disease in this paper, we have reviewed particular diseases that are may be of interest to the general physician and pediatric ophthalmologists. This paper aims to review the ocular manifestations of various pediatric diseases. HYPERTHYROIDISMHyperthyroidism is caused by over secretion of thyroid hormone; during childhood, it is caused by Graves' hyperthyroidism, the most common cause of pediatric hyperthyroidism [1]. In children, the incidence of Graves' disease is about 1:10,000 [2]. Graves' hyperthyroidism is an autoimmune disorder; secretion of thyroidstimulating immunoglobulin that binds to and triggers the Gprotein-coupled thyroid-stimulating hormone (TSH) receptor results in diffuse enlargement of the thyroid gland. Other etiologies of hyperthyroidism include gain-of-function germline mutations in the TSH receptor, which are detected in both familial and sporadic cases of non-autoimmune hyperthyroidism. These subjects, whose disease can occur in the infantile period or in later childhood, have a hyperplastic thyroid gland with goiter and decreased levels of TSH.Childhood onset Graves' ophthalmopathy is uncommon and occurs mostly in girls. Pediatric diseases are important because diagnosis and care for these can be complex. Among them, specific diseases have been associated with ocular involvement. This review presents the ocular manifestations of various pediatric diseases relevant to the clinician. An array of ocular manifestations of hyperthyroidism, hypoparathyroidism, diabetes mellitus, porphyria, cystinosis, mucopolysaccharidosis, Wilson disease, juvenile idiopathic arthritis, systemic lupus erythematosus, Marfan syndrome, Weill-Marchesani syndrome are describ ed. In this review we will review ocular manifestations of systemic pediatric diseases for comprehensive understanding of eye involvement. With this review, authors can recognize the ocular manifestations for diagnosis and management of pediatric systemic diseases.

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An evaluation of baseline risk factors predicting severity in juvenile idiopathic arthritis associated uveitis and other chronic anterior uveitis in early childhood

Cited by 212 publications

References 24 publications

Juvenile idiopathic arthritis-associated uveitis

Juvenile idiopathic arthritis-associated uveitis

Limited value of cyclosporine A for the treatment of patients with uveitis associated with juvenile idiopathic arthritis

Ocular Manifestations of Pediatric Systemic Disease

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