title: Treatment of juvenile idiopathic arthritis-associated uveitis: challenges and update.
abstract: OBJECTIVE
  To update the current understanding of the risk factors for poor outcomes in juvenile idiopathic arthritis-related uveitis. In addition, current therapies, both traditional and biological, are reviewed.
  
  
  RESULTS
  Male sex, independent of age or antinuclear antibody status, is associated with increased ocular morbidity. Having anterior chamber inflammation on first exam increases the risk of developing vision-threatening eye complications. Presence of one complication increases the risk of developing another. Risk of cataract development associated with topical glucocorticoid use is better defined. Longer duration of remission on therapy has been found to decrease the risk of disease flare after discontinuation of methotrexate. Recent studies of both nonbiological and biological therapies for arthritis-related uveitis are discussed.
  
  
  CONCLUSIONS
  With a better understanding of risk factors associated with the ocular morbidity of uveitis associated with juvenile idiopathic arthritis, aggressive therapies can be targeted for improved visual outcomes. Alternative treatments to avoid long-term corticosteroid use include the use of antimetabolites and biological therapies. More prospective comparator studies and/or use of multicenter databases are needed to better understand best treatments.
authors: Duke University, Durham, North Carolina, USA. egla.rabinovich@duke.edu
authors: C Egla
authors: CE
authors: Rabinovich
mesh_terms: D060433:Administration, Ophthalmic; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000963:Antimetabolites / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications* / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D012307:Risk Factors; D014605:Uveitis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000305:Adrenal Cortex Hormones; D000963:Antimetabolites; D001688:Biological Products; D008727:Methotrexate