Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss

Am J Ophthalmol. 2007 May;143(5):840-846. doi: 10.1016/j.ajo.2007.01.033. Epub 2007 Mar 23.


Purpose: To estimate the incidences of ocular complications and vision loss in patients with juvenile idiopathic arthritis (JIA)-associated uveitis, to describe risk factors for vision loss, and to describe the association between therapy and complications and vision loss.

Design: Retrospective cohort study.

Methods: setting: Single-center, academic practice. study population: A total of 75 patients with JIA-associated uveitis evaluated between July 1984 and August 2005. procedures: Clinical data on these patients were analyzed. outcome measures: Occurrence of ocular complications and visions of 20/50 or worse and 20/200 or worse.

Results: Over a median follow-up of three years, the incidence of any ocular complication was 0.33/eye-year (EY). Rates of vision loss to 20/50 or worse and 20/200 or worse were 0.10/EY and 0.08/EY, respectively. Risk factors at presentation for incident vision loss included presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal intraocular pressure (IOP). During follow-up, ocular inflammation > or = 0.5+ cells was associated with an increased risk of visual impairment (relative risk [RR] = 2.02, P = .006) and of blindness (RR = 2.99, P = .03). Immunosuppressive drug therapy reduced the risk of hypotony by 74% (P = .002), epiretinal membrane formation by 86% (P = .05), and blindness in the better eye by 60% (P = .04).

Conclusions: Incident vision loss and complications were common. Presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal IOP at presentation were associated with vision loss during follow-up. Use of immunosuppressive drugs reduced the risk of some ocular complications and of blindness in the better-seeing eye.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / diagnosis
  • Arthritis, Juvenile / drug therapy
  • Child
  • Child, Preschool
  • Eye Diseases / diagnosis
  • Eye Diseases / drug therapy
  • Eye Diseases / etiology*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Infant
  • Male
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Risk Factors
  • Uveitis, Anterior / complications*
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy
  • Vision Disorders / diagnosis
  • Vision Disorders / drug therapy
  • Vision Disorders / etiology
  • Visual Acuity*


  • Immunosuppressive Agents
  • Prednisone