Effect of Janus Kinase Inhibitor Treatment on Anterior Uveitis and Associated Macular Edema in an Adult Patient with Juvenile Idiopathic Arthritis

Ocul Immunol Inflamm. 2019;27(8):1232-1234. doi: 10.1080/09273948.2019.1605453. Epub 2019 Jul 3.

Abstract

Purpose: To report a case of effective Janus kinase inhibitor treatment in a case of anterior uveitis complicated by macular edema in a patient with juvenile idiopathic arthritis.Case report: A 22-year-old woman suffering from JIA-associated anterior uveitis since the age of 2 years presented with recurrent active uveitis and macular edema in both eyes responding only to intraocular dexamethasone implants in the past while several other DMARD therapies including biologicals failed to control activity and edema. After starting treatment with tofacitinib 5 mg twice daily arthritis, uveitis, and macular edema were controlled without any further steroid implants.Conclusion: In this case, Janus kinase inhibitor represented a successful strategy for severe refractory uveitis and ME and therefore Janus kinase inhibitor may be an option in selected cases not responding properly to conventional synthetic and biologic DMARDs or to intraocular steroid implants.

Keywords: Janus Kinase inhibitor; juvenile idiopathic arthritis; macular edema; uveitis.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Administration, Oral
  • Arthritis, Juvenile / complications*
  • Female
  • Humans
  • Janus Kinase Inhibitors / administration & dosage
  • Macula Lutea / pathology*
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Piperidines / administration & dosage*
  • Pyrimidines / administration & dosage*
  • Pyrroles / administration & dosage*
  • Tomography, Optical Coherence / methods
  • Uveitis, Anterior / complications*
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy
  • Visual Acuity*
  • Young Adult

Substances

  • Janus Kinase Inhibitors
  • Piperidines
  • Pyrimidines
  • Pyrroles
  • tofacitinib