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


METHODS
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.
Thorne
Jennifer E
JE
Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. jthorne@jhmi.edu
Woreta
Fasika
F
Kedhar
Sanjay R
SR
Dunn
James P
JP
Jabs
Douglas A
DA
D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014786:Vision Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014792:Visual Acuity
D007166:Immunosuppressive Agents; D011241:Prednisone