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Arnd Heiligenhaus, Carsten Heinz; Uveitis Persisting Into Adulthood In Patients With Juvenile Idiopathic Arthritis: Comparison With A Population-based Study Population. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5499.
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Juvenile idiopathic arthritis (JIA) is frequently associated with a vision-threatening chronic uveitis, which may continue into adulthood. This study aimed to determine the predicting factors for uveitis continuing into adulthood.
Data from 32 JIA patients in whom chronic uveitis continued into adulthood were compared with those from a group of 91 representative uveitis children from a population-based registry of JIA patients.
All of the adults with JIA-related uveitis (median age 25 years) had chronic uveitis with insidious onset of flare (anterior 94%, bilateral 73%), and 44% of them had persistent arthritis activity. Predictors of uveitis continuation were later uveitis and arthritis onset (p<0.001), HLA-B27 positivity (p=0.032), and presence of uveitis complications (p=0.002) and poor vision (p=0.005) at initial presentation, but not gender, ANA status at disease onset, and time interval between onset of arthritis and uveitis. At final documentation, 93% had uveitis complications, 66% had had eye surgery.
Patients with a chronic course of JIA-related uveitis persisting into adulthood often present with complications and poor vision at initial presentation, late disease onset, extended form of oligoathritis, and HLA-B27 positivity and arthritis activity is frequently ongoing. The complication rate increases with uveitis duration.
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