Visual outcomes in children with juvenile idiopathic arthritis-associated uveitis.
OBJECTIVE
To analyze visual outcomes in children affected by juvenile idiopathic arthritis (JIA)-associated uveitis.


METHODS
Retrospective interventional case series.


METHODS
Eighty-nine children with JIA-associated uveitis.


METHODS
Charts of children with JIA-associated uveitis were reviewed.


METHODS
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.
Kump
Leila I
LI
Massachusetts Eye Research and Surgery Institute, Cambridge, Massachusetts, USA.
Castañeda
René A Cervantes
RA
Androudi
Sofia N
SN
Reed
George F
GF
Foster
C Stephen
CS
D000293:Adolescent; D017668:Age of Onset; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D014606:Uveitis, Anterior / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000974:Antibodies, Antinuclear; D005938:Glucocorticoids; D007155:Immunologic Factors