Analysis of Pediatric Uveitis Cases at a Tertiary Referral Center

Optical coherence tomography imaging in uveitis

“…Maculopathy has been documented by OCT in 84 % of eyes with JIA-associated uveitis [57], a much higher figure compared to previous reports mostly based on ophthalmoscopic findings (3.9-26 %) [61][62][63][64]. Macular changes determined by OCT included perifoveolar thickening in 74 %, macular edema in 48 %, foveal detachment in 18 %, and atrophic changes in 10 % of eyes with JIA-associated uveitis [57].…”

Juvenile idiopathic arthritis-associated uveitis

“…The overall incidence of uveitis in the paediatric population, reported in a study from Finland, was 4.3 per 100,000/year and prevalence of 27.9 per 100,000 [5]. When broken down by aetiology, the prevalence of JIA-U among all causes of paediatric uveitis varies widely by referral centre, ranging from 15-67 % across centres in Europe, North America and Israel [4,[6][7][8][9]. The variation in these figures may partly be due to the referral cohorts from which the patients are selected, however, it should also be noted that uveitis can precede a diagnosis of arthritis in 3-7 % of children with JIA [10] and thus children presenting with uveitis need careful assessment for underlying systemic or infectious disease.…”

Importance of recognizing and preventing blindness from juvenile idiopathic arthritis–associated uveitis

“…tory to conservative measures. One study from a tertiary care center examining 89 children with JIA-associated uveitis over 18 years showed that 73% of these children were receiving IMT and 40% were treated with IMT and NSAIDs (6). A stepladder approach can be used when deciding upon systemic medication for ocular inflammation, requiring regular examinations and monitoring for drug toxicity (32).…”

“…One of the most ocularly pernicious forms of uveitis, first described in 1910 (3), is associated with juvenile idiopathic arthritis (JIA), which was previously known as juvenile rheumatoid arthritis or juvenile chronic arthritis. Children younger than 16 years of age represent 5-10% of the population with uveitis (4), and JIA is associated with many of these cases (5,6). Complications from JIA-associated uveitis are well known, especially considering the disease is often occult and not realized by the physician or even the patient until chronic changes and permanent vision loss have occurred.…”

“…The annual incidence of all childhood uveitis is estimated to be 4.3-6.9 per 100,000 in North America and ϳ30 per 100,000 in Europe (24 -26). JIA reportedly has been associated with anywhere from 3.3-81.5% of cases, with most reports ranging between 10% and 35% (6).…”