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J. E. Thorne, F. A. Woreta, J. P. Dunn, Jr., D. A. Jabs; Risk of Cataract Development Among Children With Juvenile Idiopathic Arthritis (JIA)-Associated Chronic Anterior Uveitis Treated With Topical Corticosteroids. Invest. Ophthalmol. Vis. Sci. 2009;50(13):284.
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© ARVO (1962-2015); The Authors (2016-present)
To report any increased risk of cataract development among patients treated with variable doses of topical corticosteroids among children with juvenile idiopathic arthritis (JIA)-associated uveitis.
Retrospective clinical data on 75 patients with JIA-associated uveitis observed from July 1984 through August 2005 were collected and analyzed. Incidence of new-onset cataract development and risk factors for cataract development including use of topical corticosteroids were evaluated.
Over a median follow-up of 3 years (mean: 4.6 years; range: 6 months to 15 years), the incidence of new-onset cataract was 0.05/eye-year (EY, 95% confidence interval [CI]: 0.02/EY, 0.09/EY). Of the 60 eyes in 40 patients who received chronic topical corticosteroid therapy, the incidence of cataract development was 0.01/EY for eyes treated with 3 drops daily or less and 0.16/EY (P = 0.0006 for log rank test) for eyes treated with >3 drops daily. Among eyes of patients receiving ≤ 2 drops daily, the incidence of cataract was zero (one-sided 95% CI: 0.03/EY). After controlling for the presence of active uveitis, concomitant use of other forms of corticosteroids (i.e., oral prednisone), and use of immunosuppressive drug therapy in a time-dependent fashion, treatment with ≤ 3 drops daily of topical corticosteroid was associated with a 87% lower risk of cataract development compared to those eyes treated with >3 drops daily (relative risk = 0.13, 95% CI: 0.02, 0.69, P = 0.017).
The rate of cataract development in our cohort was lower than that observed in adult patients with uveitis (~0.08-0.10/EY). Chronic topical corticosteroid use at doses of 3 drops daily or less was associated with a small risk of cataract development during the period of observation.
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