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Maria Papadopoulou, Madeleine Zetterberg, Solveig Oskarsdottir, Marita Andersson Grönlund; Assessment of the Outcome of Ophthalmological Screening of Children with Juvenile Idiopathic Arthritis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4488.
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© ARVO (1962-2015); The Authors (2016-present)
The group under study is comprised of all children with juvenile idiopathic arthritis (JIA) who has been screened for uveitis at the Queen Silvia Children's Hospital, Gothenburg, Sweden between 2002 and 2011. The aims were 1) to describe the JIA-subgroups as defined by the International League of Associations for Rheumatology (ILAR) criteria, 2) to describe the children developing uveitis in order to find possible predictors for risk of uveitis and 3) to determine the 5-year-incidence and the complications of uveitis in this JIA-population.
Medical records of 299 children with JIA during 10 years were analyzed retrospectively.
The children were categorized in the following JIA-subgroups as defined by the International League of Associations for Rheumatology (ILAR) criteria: oligoarthritis (n=172; 57%), RF(-) polyarthritis (PA) (n=63; 21%), RF(+) PA (n=10; 3%), systemic (n=12; 4%), enthesitis-related (n=17; 5%), psoriatic (n=20; 6%) and undifferentiated (n=5; 2%). Uveitis was found in 11% of the JIA-group (32/299), bilateral uveitis was found in 25 children (78%). Oligoarthritis was most prevalent (n=24), followed by RF(-) PA (n=7) and systemic (n=1). 31/32 children were found to be ANA(+) (totally 54%). Sex ratio was 3.5:1 (girls:boys). The mean age of arthritis onset in children who developed uveitis was 3.5 years (range 1-10). In one girl uveitis was diagnosed before the onset of arthritis. The mean time interval between diagnosis of arthritis and uveitis was 17 months (range 1-60). The 5-year-incidence of uveitis was 19.7% (15/76 completed a 5-year follow-up). Of all 32 children, only one developed uveitis between the 4th and the 5th year after arthritis onset . The following complications were noted: posterior synechiae (37%), ocular hypertension (25%), cataract (19%), band keratopathy (15%), secondary glaucoma (9%), vitritis (9%), macular oedema (3%) and blindness in one eye (3%). 13 eyes of 8 children required eye surgery for uveitis complications.
Most of the epidemiological characteristics found in the present study are in accordance with previous studies. The vast majority (96%) of our JIA-group developed uveitis within the first four years after arthritis onset, a fact that accentuates the importance of early initiation of ophthalmological screening and more frequent regular follow-up examinations within the first four years after arthritis onset.
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