Abstract
Purpose:
To evaluate laser flare photometry values for monitoring children with JIA-associated uveitis.
Methods:
Retrospective chart review. We analyzed children with JIA-associated uveitis followed between 2000 and 2014 at La pitié Salpétrière Hospital (Paris France). We defined two groups of patients characterized by the decrease of flare values one month after treatment intensification (more 50% flare decrease in group 1 and less 50% flare decrease in group 2). Complications enumerated at baseline and during follow up (at 5 years and at last visit) were compared in each group and in overall population.
Results:
Fifty four children (99 eyes) were included in this study (mean follow up 8.2 years+/-4.5 ). Ten eyes were excluded from the analysis because the initial flare value was inferior to 12 ph/ms. Complications of uveitis were present in 68 eyes (76%) at baseline and in 76 eyes (85%) at last visit. Flare values one month after treatment intensification decreased of more than 50% in 59 eyes (66%) (group 1) and of less than 50% in 30 eyes (33%) (group 2). Group 1 children developed significantly less complications as compared to group 2 children at 5 years (p=0.03), band keratopathy (p=0.003), cataract surgery (p=0.003), glaucoma (p=0.003) trabeculectomy (p=0.004), macular oedema (p=0.001), papillar edema (p=0.02)) and at last visit (p=0.004), band keratopathy (p=0.004), cataract surgery (p=0.02), trabeculectomy (p=0.006), papillar edema (p=0.02)). They also kept a better visual acuity (p<0.0001 at both 5 years and last visit) and required less systemic immunosupressive treatments (sixth treatment line at last visit p=0.01). Flare photometry values were significantly different between the 2 groups at both 5 years (p=0,002) and last visit (p=0,0001).
Conclusions:
Decrease of laser flare photometry values one month after treatment intensification is a good predictive value of complications and low visual acuity over long-term follow-up in children with JIA-associated uveitis.