title: Evidence-based, interdisciplinary guidelines for anti-inflammatory treatment of uveitis associated with juvenile idiopathic arthritis.
abstract: Uveitis in juvenile idiopathic arthritis (JIA) is frequently associated with the development of complications and visual loss. Topical corticosteroids are the first-choice therapy, and immunosuppression is commonly used. However, treatment has not been standardized. Representatives from the German Ophthalmological Society, Society for Childhood and Adolescent Rheumatology, and the German Society for Rheumatology reached consensus on a standardized treatment strategy according to disease severity in the individual patient. The recommendations were based on a systematic literature analysis in MEDLINE and consensus expert meetings. Evidence and recommendations were graded, and an algorithm for anti-inflammatory treatment and final statements confirmed in a Delphi method. An interdisciplinary, evidence-based treatment guideline for JIA uveitis is presented.
authors.affiliation: Department of Ophthalmology, St. Franziskus Hospital, Hohenzollernring 74, 48145 Muenster, Germany. arnd.heiligenhaus@uveitis-zentrum.de
authors.forename: A
authors.initials: A
authors.lastname: Heiligenhaus
authors.forename: H
authors.initials: H
authors.lastname: Michels
authors.forename: C
authors.initials: C
authors.lastname: Schumacher
authors.forename: I
authors.initials: I
authors.lastname: Kopp
authors.forename: U
authors.initials: U
authors.lastname: Neudorf
authors.forename: T
authors.initials: T
authors.lastname: Niehues
authors.forename: H
authors.initials: H
authors.lastname: Baus
authors.forename: M
authors.initials: M
authors.lastname: Becker
authors.forename: B
authors.initials: B
authors.lastname: Bertram
authors.forename: G
authors.initials: G
authors.lastname: Dannecker
authors.forename: C
authors.initials: C
authors.lastname: Deuter
authors.forename: I
authors.initials: I
authors.lastname: Foeldvari
authors.forename: M
authors.initials: M
authors.lastname: Frosch
authors.forename: G
authors.initials: G
authors.lastname: Ganser
authors.forename: M
authors.initials: M
authors.lastname: Gaubitz
authors.forename: G
authors.initials: G
authors.lastname: Gerdes
authors.forename: G
authors.initials: G
authors.lastname: Horneff
authors.forename: A
authors.initials: A
authors.lastname: Illhardt
authors.forename: F
authors.initials: F
authors.lastname: Mackensen
authors.forename: K
authors.initials: K
authors.lastname: Minden
authors.forename: U
authors.initials: U
authors.lastname: Pleyer
authors.forename: M
authors.initials: M
authors.lastname: Schneider
authors.forename: N
authors.initials: N
authors.lastname: Wagner
authors.forename: M
authors.initials: M
authors.lastname: Zierhut
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000150:complications* / Q000276:immunology; D002648:Child; D003299:Cooperative Behavior; D003697:Delphi Technique; D019317:Evidence-Based Medicine / Q000592:standards*; D005858:Germany; D006801:Humans; D033183:Interdisciplinary Communication; D009885:Ophthalmology / Q000592:standards*; D010348:Patient Care Team; D012008:Recurrence; D012219:Rheumatology / Q000592:standards*; D016896:Treatment Outcome; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents
references.citation: Clin Exp Rheumatol. 1998 Jul-Aug;16(4):469-71
references.pmid: 9706430
references.citation: Eye (Lond). 2009 May;23(5):1192-8
references.pmid: 18551142
references.citation: Rheumatology (Oxford). 2005 Mar;44(3):405
references.pmid: 15637094
references.citation: Am J Ophthalmol. 1974 Sep;78(3):415-28
references.pmid: 4472398
references.citation: Asian Pac J Allergy Immunol. 1997 Jun;15(2):71-5
references.pmid: 9346269
references.citation: Am J Ophthalmol. 1969 Mar;67(3):383-7
references.pmid: 4304465
references.citation: Ophthalmology. 1998 Nov;105(11):2028-34
references.pmid: 9818601
references.citation: Am J Ophthalmol. 1975 Jun;79(6):1026-33
references.pmid: 1079693
references.citation: Ophthalmology. 1987 Oct;94(10):1242-8
references.pmid: 3684202
references.citation: J Rheumatol. 2004 Feb;31(2):390-2
references.pmid: 14760812
references.citation: Arthritis Rheum. 2001 Jun;44(6):1411-5
references.pmid: 11407702
references.citation: Arthritis Rheum. 2004 Jul;50(7):2191-201
references.pmid: 15248217
references.citation: Klin Padiatr. 2008 Nov-Dec;220(6):392-402
references.pmid: 18949678
references.citation: Ophthalmology. 2002 Jan;109(1):137-42
references.pmid: 11772593
references.citation: Am J Ophthalmol. 2000 Aug;130(2):240-1
references.pmid: 11004305
references.citation: Am J Ophthalmol. 2005 Sep;140(3):509-16
references.pmid: 16196117
references.citation: Ann Rheum Dis. 2007 Jun;66(6):840-1
references.pmid: 17170050
references.citation: Br J Ophthalmol. 1982 Jun;66(6):389-91
references.pmid: 7044412
references.citation: Rheumatology (Oxford). 2007 Jun;46(6):1015-9
references.pmid: 17403710
references.citation: N Engl J Med. 1992 Apr 16;326(16):1043-9
references.pmid: 1549149
references.citation: Ophthalmology. 1985 Apr;92(4):467-71
references.pmid: 4000641
references.citation: J Rheumatol. 2005 Feb;32(2):362-5
references.pmid: 15693100
references.citation: Klin Monbl Augenheilkd. 2007 Jun;224(6):469-72
references.pmid: 17594614
references.citation: Reumatismo. 1977 Jan-Mar;29(1):7-32
references.pmid: 373044
references.citation: N Engl J Med. 2008 Aug 21;359(8):810-20
references.pmid: 18716298
references.citation: J Rheumatol. 2007 May;34(5):1146-50
references.pmid: 17343318
references.citation: Arch Ophthalmol. 2003 Dec;121(12):1716-21
references.pmid: 14662591
references.citation: J Rheumatol. 1997 Dec;24(12):2444-50
references.pmid: 9415656
references.citation: Acta Ophthalmol (Copenh). 1991 Apr;69(2):145-8
references.pmid: 1872132
references.citation: Arthritis Rheum. 2005 Feb 15;53(1):18-23
references.pmid: 15696578
references.citation: Acta Paediatr. 2009 Mar;98(3):584-5
references.pmid: 18976362
references.citation: J Rheumatol. 2006 Jan;33(1):198; author reply 198
references.pmid: 16395772
references.citation: Klin Monbl Augenheilkd. 2007 Jun;224(6):520-5
references.pmid: 17594624
references.citation: Br J Ophthalmol. 1998 Jul;82(7):737-42
references.pmid: 9924362
references.citation: J Rheumatol. 2003 Jun;30(6):1277-9
references.pmid: 12784403
references.citation: Rheumatology (Oxford). 2008 Mar;47(3):339-44
references.pmid: 18238789
references.citation: Rheumatology (Oxford). 2001 Aug;40(8):907-13
references.pmid: 11511760
references.citation: Ophthalmology. 1997 Feb;104(2):236-44
references.pmid: 9052627
references.citation: Ophthalmologe. 1996 Dec;93(6):745-8
references.pmid: 9081536
references.citation: Z Rheumatol. 1982 May-Jun;41(3):105-6
references.pmid: 7202309
references.citation: Klin Monbl Augenheilkd. 1987 Nov;191(5):332-3
references.pmid: 3430996
references.citation: Ophthalmology. 2001 Nov;108(11):2071-5
references.pmid: 11713082
references.citation: J Pediatr. 2006 Oct;149(4):572-5
references.pmid: 17011337
references.citation: Eye (Lond). 2000 Jun;14 ( Pt 3A):340-3
references.pmid: 11026996
references.citation: Arch Ophthalmol. 1977 Oct;95(10):1794-7
references.pmid: 303091
references.citation: Semin Arthritis Rheum. 2004 Dec;34(3):602-9
references.pmid: 15609264
references.citation: J Rheumatol. 1986 Feb;13(1):118-23
references.pmid: 3517321
references.citation: J Pediatr. 1998 Aug;133(2):266-8
references.pmid: 9709718
references.citation: Graefes Arch Clin Exp Ophthalmol. 2006 Mar;244(3):281-90
references.pmid: 16228217
references.citation: Br J Ophthalmol. 1979 Nov;63(11):762-7
references.pmid: 389282
references.citation: Rheumatology (Oxford). 2006 Aug;45(8):982-9
references.pmid: 16461435
references.citation: Am J Ophthalmol. 2008 Dec;146(6):802-12.e1
references.pmid: 18579112
references.citation: Ophthalmology. 2006 Dec;113(12):2317-23
references.pmid: 16996615
references.citation: Ophthalmology. 2010 Jul;117(7):1436-41
references.pmid: 20363502
references.citation: Arch Ophthalmol. 2008 Feb;126(2):200-5
references.pmid: 18268210
references.citation: Pediatrics. 2006 May;117(5):1843-5
references.pmid: 16651348
references.citation: Ophthalmology. 2009 Aug;116(8):1544-51, 1551.e1
references.pmid: 19651312
references.citation: Am J Ophthalmol. 2003 May;135(5):676-80
references.pmid: 12719076
references.citation: Eur J Ophthalmol. 2007 Sep-Oct;17(5):743-8
references.pmid: 17932849
references.citation: Ophthalmology. 2006 May;113(5):860-4.e2
references.pmid: 16545455
references.citation: Ann Rheum Dis. 2007 Apr;66(4):548-50
references.pmid: 17068061
references.citation: Ocul Immunol Inflamm. 2004 Sep;12(3):169-92
references.pmid: 15385194
references.citation: Br J Ophthalmol. 2011 Feb;95(2):209-13
references.pmid: 20584711
references.citation: Surv Ophthalmol. 1991 Mar-Apr;35(5):369-85
references.pmid: 2038720
references.citation: Surv Ophthalmol. 1990 Jan-Feb;34(4):253-67
references.pmid: 2188388
references.citation: Ophthalmology. 2001 Jun;108(6):1134-9
references.pmid: 11382642
references.citation: Am J Ophthalmol. 1996 Aug;122(2):171-82
references.pmid: 8694085
references.citation: Klin Monbl Augenheilkd. 2007 Jun;224(6):526-31
references.pmid: 17594625
references.citation: Rheumatol Int. 2005 Apr;25(3):169-78
references.pmid: 15688190
references.citation: Ophthalmology. 2008 Aug;115(8):1416-21, 1421.e1
references.pmid: 18221998
references.citation: Arthritis Rheum. 2008 May;58(5):1555-6; author reply 1556-7
references.pmid: 18438848
references.citation: Ophthalmology. 2001 Apr;108(4):765-72
references.pmid: 11297495
references.citation: Br J Ophthalmol. 2007 Oct;91(10):1341-4
references.pmid: 17556427
references.citation: Br J Ophthalmol. 1985 Feb;69(2):120-5
references.pmid: 3881125
references.citation: Am J Ophthalmol. 2007 May;143(5):840-846
references.pmid: 17362866
references.citation: Ophthalmologe. 2005 May;102(5):477-84
references.pmid: 15711944
references.citation: Br J Ophthalmol. 2007 Feb;91(2):180-4
references.pmid: 16825275
references.citation: Am J Ophthalmol. 2003 Jun;135(6):763-71
references.pmid: 12788114
references.citation: J Rheumatol. 2002 Nov;29(11):2446-53
references.pmid: 12415607
references.citation: Arthritis Rheum. 1977 Mar;20(2 Suppl):195-9
references.pmid: 318120
references.citation: Am J Ophthalmol. 2003 Jun;135(6):879-84
references.pmid: 12788129
references.citation: J Rheumatol. 2001 Feb;28(2):309-12
references.pmid: 11246667
references.citation: J Rheumatol. 1994 Dec;21(12):2370-5
references.pmid: 7699645
references.citation: Am J Ophthalmol. 2009 Apr;147(4):667-678.e5
references.pmid: 19195641
references.citation: Clin Exp Ophthalmol. 2005 Oct;33(5):461-8
references.pmid: 16181269
references.citation: Ophthalmology. 2006 Feb;113(2):308-14
references.pmid: 16406545
references.citation: J Pediatr Ophthalmol Strabismus. 1999 May-Jun;36(3):125-8
references.pmid: 10358815
references.citation: Arch Ophthalmol. 1986 Jun;104(6):847-51
references.pmid: 3521558
references.citation: Am J Dis Child. 1988 Dec;142(12):1289-92
references.pmid: 3195528
references.citation: Eye (Lond). 2009 Apr;23(4):910-4
references.pmid: 18464803
references.citation: Ophthalmology. 2003 May;110(5):1061-5
references.pmid: 12750115
references.citation: Am J Ophthalmol. 2003 Jun;135(6):757-62
references.pmid: 12788113
references.citation: Ophthalmic Res. 2009;42(2):81-6
references.pmid: 19478546
references.citation: Br J Ophthalmol. 2003 Jul;87(7):879-84
references.pmid: 12812891
references.citation: Klin Monbl Augenheilkd. 2007 Jun;224(6):516-9
references.pmid: 17594623
references.citation: Br J Ophthalmol. 2007 Mar;91(3):319-24
references.pmid: 17035274
references.citation: Br J Ophthalmol. 2005 Jul;89(7):806-8
references.pmid: 15965154
references.citation: J Rheumatol. 1985 Oct;12(5):967-70
references.pmid: 4087273
references.citation: Rheumatol Int. 2003 Sep;23(5):258-61
references.pmid: 12687288