Prevalence, risk factors, and outcome of uveitis in juvenile idiopathic arthritis: A long‐term followup study

Abstract

Objective. To assess the prevalence, risk factors, and long-term outcome of uveitis in patients with juvenile idiopathic arthritis (JIA).Methods. An inception cohort of all 1,081 patients diagnosed as having JIA at a single tertiary care center was established. A questionnaire and followup telephone calls were used to confirm the diagnosis of uveitis. Ophthalmologists' records of patients with uveitis were collected. Kaplan-Meier and Cox regression analyses were used to assess risk factors for developing uveitis and for complications of uveitis.Results. After a mean followup time of 6.9 years, 142 of 1,081 patients (13.1%) had developed uveitis. Risk factors were young age at diagnosis, female sex, antinuclear antibody positivity, and the subtype of JIA. The relative contribution of these risk factors was different for the different subtypes of JIA. Until the end of the study, uveitis complications had developed in 53 of 142 patients with uveitis (37.3%; 4.9% of the total cohort). Only 16 of 175 involved eyes (9.1%) in 14 of 108 patients (13%; 1.3% of the total cohort) for whom ophthalmology reports were available had best corrected visual acuity less than 20/40 (mean followup time for uveitis of 6.3 years). Abnormal vision was associated with synechiae or cataract.Conclusion. Risk factors for developing uveitis were different among subtypes of JIA. The long-term outcome of JIA-associated uveitis in our cohort was excellent despite the high rate of complications.

Uveitis Events During Adalimumab, Etanercept, and Methotrexate Therapy in Juvenile Idiopathic Arthritis: Data From the Biologics in Pediatric Rheumatology Registry

“…Current studies reinforce the previous observations (7,9,10) that an early age at the onset of arthritis, oligoarticular-onset of JIA, and antinuclear antibody (ANA) positivity (10)(11)(12)(13) are the main risk factors for the development of uveitis. There is a suggested guideline (14) for the treatment of JIA-associated uveitis, but prospectively controlled data regarding treatment are sparse.…”

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].…”

Abatacept for severe anti–tumor necrosis factor α refractory juvenile idiopathic arthritis–related uveitis

“…Chronic anterior uveitis is one of the most serious manifestations of juvenile idiopathic arthritis (JIA), with the potential to cause sight-threatening ocular complications (1). Despite improvements in the treatment strategy for arthritis, less progress has been made in the treatment of uveitis, which remains one of the greatest challenges encountered by pediatric rheumatologists and ophthalmologists.…”