title: Nuclear cataract as an early predictive factor for recalcitrant juvenile idiopathic arthritis-associated uveitis.
abstract: To analyze factors predictive of having treatment-resistant uveitis in patients with juvenile idiopathic arthritis (JIA)-associated uveitis.
  
  
  
  The medical records of patients diagnosed with JIA-associated uveitis treated at a single tertiary referral center from October 2005 to March 2013 were reviewed retrospectively. The main outcome measures were demographic characteristics, ocular comorbidity, clinical course, treatments, and baseline risk factors associated with poor response to first-line therapies.
  
  
  
  A total of 96 patients (175 eyes) were included. Of these, 58 patients (108 eyes) required biologic disease-modifying antirheumatic drugs or alkylating agents for their uveitis during follow-up (recalcitrant group), and 38 patients (67 eyes) did not (nonrecalcitrant group). Eyes of the recalcitrant group tended to have a higher incidence of cataract at baseline (49%; P < 0.0001). In the nonrecalcitrant group, the most frequent complications were cataract (20.9%) and secondary glaucoma (20.9%). The mean number of flares in the recalcitrant group was significantly reduced from 3.7/eye/year prior to cataract surgery to 1.6/eye/year after (P < 0.0001). Nuclear cataract was found to be an independent predictor for a severe course of JIA-associated uveitis. Any other type of cataract, posterior synechiae, male sex, or active uveitis at baseline were not found to be independently associated with recalcitrant uveitis.
  
  
  
  Nuclear cataract at baseline evaluation is a risk factor for poor response to first-line therapies in JIA-associated uveitis patients.
authors.affiliation: Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts; Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Suelves
authors.affiliation: Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts.
authors.forename: Neerav
authors.initials: N
authors.lastname: Lamba
authors.affiliation: Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts.
authors.forename: Halea K
authors.initials: HK
authors.lastname: Meese
authors.affiliation: Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts; Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts. Electronic address: sfoster@mersi.com.
authors.forename: C Stephen
authors.initials: CS
authors.lastname: Foster
authors.affiliation: Statistical results, Valencia, Spain.
authors.forename: Jesus Maria
authors.initials: JM
authors.lastname: González-Martín
authors.affiliation: Department of Ophthalmology, University and Polytechnic Hospital La Fe, Valencia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Díaz-Llopis
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: William G
authors.initials: WG
authors.lastname: Christen
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000188:drug therapy; D002386:Cataract / Q000151:congenital* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D018501:Antirheumatic Agents