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Brian Do, Natasha V Nayak, Sanjay Kedhar, C. Michael Samson; JIA & Uveitis: The Patients' Perspective. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4130.
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© ARVO (1962-2015); The Authors (2016-present)
While studies suggest that a T-cell mediated mechanism is likely responsible for the uveitis associated with juvenile idiopathic arthritis (JIA) as well as its arthritic manifestations, many questions remain regarding their pathogenesis. In JIA patients with both articular and ocular involvement, our experience has been that the two tend to occur without chronologic relation to one another. Historical data obtained from these patients may be indicative of disparate pathophysiologic mechanisms causing the associated arthritis and uveitis, respectively.
The medical records of 285 patients currently between the ages of zero to eighteen years, who had been seen by one of two Uveitis subspecialists at the New York Eye & Ear Infirmary of Mount Sinai (NYEEIMS) were reviewed. All patients without a history of JIA-associated uveitis were excluded.Using phone numbers provided at the time of their respective encounters, attempts were made to reach the parents of each confirmed JIA uveitis patient. Once phone contact was made, verbal consent for questioning was obtained. Each consenting parent was then asked questions regarding the nature and setting of diagnosis of both JIA and associated uveitis, age at the time of diagnosis, and any perceived correlation between the arthritis and uveitis.
Of 285 patients with encounters with either one of two uveitis specialists at NYEEIMS, at least one parent of each of 19 patients was reachable by phone and provided consent for questioning regarding their children's JIA and associated uveitis.15 of 19 patients for whom historical information was provided are female. 16 of 19 patients were diagnosed with JIA prior to being diagnosed with uveitis; amongst these patients, the median age reported at time of diagnosis of JIA was 21.5 months. In those patients diagnosed initially with uveitis, the ages at the time of diagnosis were 5, 10, and 13 years, respectively.All parents denied any perceived relation between the two entities. 19 of 19 patients reportedly had flares of either the uveitis or arthritis without manifestations of the other.
Although the reliability of historical data can be questionable, the absolute lack of perceived correlation between arthritis and uveitis in JIA patients is suggestive of, and supports the idea of different pathophysiologic mechanisms. Further investigation into the cellular mechanisms of joint and eye inflammation in JIA patients is warranted.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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