[Eye complications in chronic juvenile arthritis].
BACKGROUND
The relationship between uveitis anterior in childhood and juvenile chronic arthritis (JCA, respectively JRA) has been known since 1950. In a review, the clinical picture of uveitis anterior, its prevalence, pathogenesis, prognosis and current therapy of ocular complications are presented. In addition, we will report our results of a clinical study.


METHODS
In a cross-sectional study, 64 patients with juvenile chronic arthritis (JCA) had an ophthalmological screening for eye complications either from the disease itself or from the treatment.


RESULTS
In 16% of the patients, an iridocyclitis was found, in one case acute, in 9 cases chronic. The cases of chronic uveitis anterior showed in 43% a combination with the classic risk factors (ANA-positive, oligoarticular, female). At the beginning of uveitis, the patients had a mean age of 81 months, at the beginning of JCA disease a mean age of 37 months. Four of 10 patients (= 40%) had eye complications from uveitis (cataract, posterior synechiae, glaucoma). Complications from therapy were found in 27%, mostly cataract as a complication of systemic and topical steroid treatment. Eighteen % had a visual acuity of 0.4 or less.


CONCLUSIONS
Because of the often asymptomatic progression of chronic uveitis anterior, the risk of severe undetected eye complications is high. Therefore, an intensive interdisciplinary cooperation between rheumatologists, pediatrics and ophthalmologists is required.
Körner-Stiefbold
U
U
Universitäts-Augenklinik, Bern.
Sauvain
M J
MJ
Gerber
N
N
Garweg
J
J
Körner
F
F
Gugler
E
E
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000032:analysis; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015863:Iridocyclitis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D014606:Uveitis, Anterior / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear
Augenkomplikationen bei juveniler chronischer Arthritis.