Visual Outcomes in Children With Juvenile Idiopathic Arthritis-Associated Uveitis

Ophthalmology. 2006 Oct;113(10):1874-7. doi: 10.1016/j.ophtha.2006.05.016. Epub 2006 Aug 1.

Abstract

Purpose: To analyze visual outcomes in children affected by juvenile idiopathic arthritis (JIA)-associated uveitis.

Design: Retrospective interventional case series.

Participants: Eighty-nine children with JIA-associated uveitis.

Methods: Charts of children with JIA-associated uveitis were reviewed.

Main outcome measure: Change in patients' visual acuities (VAs).

Results: Of 269 children with uveitic syndromes referred, 89 (33%) had JIA-associated uveitis. The process was bilateral in 76 children. Seventy-three patients were female, and 84% of patients were Caucasian. Mean age of onset of uveitis was 5.7 years. Mean follow-up was 2.96 years. Antinuclear antibody positivity was detected in 56 patients, 44 of them female. Patients with JIA-associated uveitis developed numerous complications in the course of their disease: of 165 affected eyes, 105 (64%) developed cataracts, 33 (20%) developed increased intraocular pressure, and 76 (46%) developed band keratopathy; posterior synechiae were present in 96 (58%). Of 89 children, 73% were treated with immunomodulators, 40% were treated with nonsteroidal antiinflammatory agents alone or in combination with immunomodulators, and 21% were treated with topical and/or systemic steroids. Of 65 children who required immunomodulation, only one chemotherapeutic agent was used in 30, two agents in 21, and > or =3 in 14. Visual acuities of 65 children (122 eyes) were documented and compared at standard intervals. By mixed-models linear regression, improvement in VA of 0.03 logarithm of the minimum angle of resolution units per year was not found to be statistically significant (standard error, 0.02, P = 0.089).

Conclusions: Juvenile idiopathic arthritis-associated uveitis is a sight-threatening disease. However, much of the children's vision can be preserved if patients are treated appropriately.

MeSH terms

  • Adolescent
  • Age of Onset
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antibodies, Antinuclear / blood
  • Arthritis, Juvenile / complications
  • Arthritis, Juvenile / drug therapy
  • Arthritis, Juvenile / physiopathology*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use
  • Infant
  • Male
  • Retrospective Studies
  • Uveitis, Anterior / drug therapy
  • Uveitis, Anterior / etiology
  • Uveitis, Anterior / physiopathology*
  • Visual Acuity / physiology*

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Antinuclear
  • Glucocorticoids
  • Immunologic Factors