title: Juvenile idiopathic arthritis-associated uveitis at an Italian tertiary referral center: clinical features and complications.
abstract: OBJECTIVE
  To describe the frequencies and risk factors of ocular complications and poor visual outcomes in children with juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  Retrospective cohort study, including 69 consecutive children (116 eyes) affected by JIA-associated uveitis managed at a tertiary uveitis clinic.
  
  
  RESULTS
  The incidence of visual loss to the 20/50 or worse threshold was 0.04/eye-year (EY) and to the 20/200 or worse threshold was 0.02/EY. The most common complications at baseline were posterior synechiae (52%), band keratopathy (38%), and cataract (12%). Risk factor for a visual acuity threshold of 20/50 or worse included hypotony (p = 0.01; hazard ratio [HR] 3.7; 95% CI 1.3-10.4); anterior chamber flare >1 (p = 0.04; HR 1.3; 95% CI 0.5-3.4); a positive antinuclear antibody (ANA) (p = 0.02; HR1.4; 95% CI 0.8-2.4). Hypotony and positive ANA are also associated to the 20/200 or worse threshold (p = 0.03; HR 5.1; 95% CI 1.1-23.9 and p = 0.04; HR 1.0; 95% CI 0.4-2.3; respectively). Use of immunosuppressive drugs was associated with a reduced risk of visual loss of 20/200 or worse (odds ratio 0.14, 95% CI, 0.02-1.29; p = 0.04).
  
  
  CONCLUSIONS
  Loss of vision and ocular complications still occur among children with JIA-related uveitis. Prompt diagnosis and a strict follow up associated to immunosuppressive therapy may decrease the poor visual outcome.
authors: Ocular Immunovirology Service, University of Rome , Sapienza , Italy.
authors: Maria Pia
authors: MP
authors: Paroli
authors: Alessandro
authors: A
authors: Abbouda
authors: Lucia
authors: L
authors: Restivo
authors: Alfredo
authors: A
authors: Sapia
authors: Irene
authors: I
authors: Abicca
authors: Paola
authors: P
authors: Pivetti Pezzi
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000150:complications*; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D014792:Visual Acuity
keywords: Children; juvenile idiopathic arthritis; ocular complication; uveitis; visual acuity