Juvenile Idiopathic Arthritis Associated Uveitis in Adults: A Case Series

Camuglia, Jayne E; Whitford, Cecily; Hall, Anthony J.

doi:10.3109/09273940903118626

Cited by 15 publications

(13 citation statements)

References 15 publications

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“…26 Indeed, a limited number of long-term follow-up studies suggest that patients with JIA may suffer ongoing uveitis well into adulthood with the frequent development of ocular complications (cataract and glaucoma) and poor visual outcomes. [27][28][29][30][31] In one such study, 49% of 55 adult patients with JIA still had active uveitis after 24 years, and among these the development of cataract and secondary glaucoma had increased significantly between years 7 and 24 of disease. 31 In a retrospective analysis of 163 patients with painless anterior uveitis diagnosed over a 16-year period in England, the most significant predictor for the development of ocular complications was severe disease at onset.…”

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confidence: 96%

Juvenile Idiopathic Arthritis-Associated Uveitis: Clinical Features and Complications, Risk Factors for Severe Course, and Visual Outcome

Vitale

Graham

Boer

2013

Ocular Immunology and Inflammation

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Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease and the most prevalent systemic disorder in children with uveitis. The risk of developing uveitis is the greatest among patients with oligoarticular onset of disease. Clinical features of JIA-associated uveitis (JIAU) are nongranulomatous inflammation, anterior in location, insidious at onset, chronic course, and frequently asymptomatic in the absence of ocular structural complications. Uveitis in JIA can worsen over time with many sight-threatening complications, such as band keratopathy in the visual axis, posterior synechiae, cataract, secondary glaucoma, macular edema, hypotony, epiretinal membrane, and optic nerve edema. Different studies have pointed out that several factors are associated with poor prognosis, including young age at onset, male gender, short interval between diagnosis of arthritis and uveitis, severity of uveitis at onset, and antinuclear antibody (ANA) positivity. Although JIA associated-uveitis is still a serious blinding disease, we are at least able to identify the high-risk group.

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confidence: 96%

Juvenile Idiopathic Arthritis-Associated Uveitis: Clinical Features and Complications, Risk Factors for Severe Course, and Visual Outcome

Vitale

Graham

Boer

2013

Ocular Immunology and Inflammation

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“…22% of patients during this period were probably most actively treated for JIA, or were treated only by family doctors, who do not provide diagnostic codes; their visits were filed by doctors other than rheumatologists. As indicated by the observations by many authors [10], a significant percentage of JIA patients still have the disease after reaching adulthood, but many of them experience remission. However, they also require treatment by specialists other than rheumatologists, due to their short stature, physical disability, osteoporosis, dysfunctions of internal organs and of sight, and sometimes amyloidosis [11].…”

Section: Discussionmentioning

confidence: 98%

Juvenile idiopathic arthritis morbidity rate in rural and urban areas of Poland 2008–2012

Tłustochowicz

Śliwczyński

Iltchev

et al. 2015

Ann Agric Environ Med.

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Objective. The aim of this study was to investigate the juvenile idiopathic arthritis (JIA) morbidity rate in the Polish population, calculated per 1,000 inhabitants of a given province, taking into account the differences between urban and rural areas, gender and area of residence (province) 2008-2012. Method. From the NFZ IT systems information was obtained on the treatment of patients who had M08 and M09 juvenile arthritis, diseases classified elsewhere by the ICD-10 diagnosis code in the settlement report of the hospital. The number of patients, their gender and age at individual diagnoses were calculated based on the PESEL number provided in the statistical reports of the patient with the analysed ICD-10 diagnosis. Urban and rural cases were compared using commune zip codes. The basic for classifying the patient as a member of a urban or rural population was the zip code of the declared place of residence. Results. In Poland, the number of patients suffering from juvenile idiopathic arthritis has been increasing since 2008 -from 9.2 thousand in 2008 to 11.4 thousand in 2012. The majority were girls (approx. 62%). Most patients were living in urban areas; in 2008, 5.9 thousand: urban areas -64% of women and 36% of men; 3.2 thousand: rural areas -62% of women, 38% of men); in 2012, 7.2 thousand -urban areas); 4.2 thousand -rural areas. The morbidity indicators ranged from 0.195 -0.357 per 1,000 inhabitants, depending on the year, gender and place of residence (province and commune).

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“…In the persistent and extended oligoarticular subtypes, 30% and 38% had a VA of 20/50 or worse, respectively, and 9% and 23% had a VA of 20/200 or worse [7]. Hence, JIA-U can lead to long-term visual impairment and ocular complications, with persistent visual morbidity extending into adulthood [30, 32•]. …”

Section: Complications Of Uveitismentioning

confidence: 99%

“…In one study of 18 adult patients with JIA-U, 70% of 30 eyes were visually handicapped or blind at follow-up due to cataract, hypotony, or macular pathology [30]. A recent study by Camuglia et al [32•] reviewed the outcomes of 30 eyes in 17 adults with active JIA-U. Five patients underwent cataract surgery during childhood, and 9 patients, or 13 eyes (53%) had a new complication of cataracts or glaucoma into adulthood, with 10 eyes requiring cataract surgery and intraocular lens (IOL) implantation.…”

Section: Juvenile Idiopathic Arthritis–associated Cataractsmentioning

confidence: 99%

Prevention and Management of Cataracts in Children with Juvenile Idiopathic Arthritis–Associated Uveitis

Angeles‐Han

Yeh

2011

Curr Rheumatol Rep

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Juvenile idiopathic arthritis (JIA)-associated uveitis can be associated with vision-compromising complications such as cataracts, glaucoma, synechiae, and band keratopathy. Of these, cataracts are one of the most common sequelae of JIA-associated uveitis and can result in significant visual disability. Risk factors for cataracts include posterior synechiae and longstanding ocular inflammation. Prevention of cataract development is crucial through appropriate control of uveitis. However, not all preventive measures are successful, and further management consisting of medical and surgical techniques is often necessary. Various factors should be taken into consideration when deciding on cataract management, including timing of surgery and placement of an intraocular lens. Continued partnership between pediatric rheumatologists and pediatric ophthalmologists can help ensure favorable visual outcomes.

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Juvenile Idiopathic Arthritis Associated Uveitis in Adults: A Case Series

Abstract: JIA may be associated with ongoing uveitis and complications in adulthood.

Cited by 15 publications

References 15 publications

Juvenile Idiopathic Arthritis-Associated Uveitis: Clinical Features and Complications, Risk Factors for Severe Course, and Visual Outcome

Juvenile Idiopathic Arthritis-Associated Uveitis: Clinical Features and Complications, Risk Factors for Severe Course, and Visual Outcome

Juvenile idiopathic arthritis morbidity rate in rural and urban areas of Poland 2008–2012

Prevention and Management of Cataracts in Children with Juvenile Idiopathic Arthritis–Associated Uveitis

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