Abstract
Purpose: :
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.
Methods: :
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.
Results: :
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.
Conclusions: :
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.
Keywords: clinical (human) or epidemiologic studies: outcomes/complications • uveitis-clinical/animal model • inflammation