Visual Outcomes in Children With Juvenile Idiopathic Arthritis – Associated Uveitis

Abstract

Abstract: : Purpose: To analyze visual outcomes in children affected by JIA–associated uveitis. Methods:Charts of 89 children with JIA–associated uveitis were reviewed . Results: Among 269 children with uveitic syndromes referred to a tertiary eye center 89 (33%) had juvenile idiopathic arthritis associated uveitis. The process was bilateral in 76 children. Seventy three patients were females, 84 % of the patients were Caucasian. Mean age of onset of uveitis was 5.7 years. Mean follow–up was 2.96 years. ANA positivity was detected in 51 patients, 42 of them were females. The patients with JIA–associated uveitis developed numerous complications in the course of their disease: among 165 affected eyes 105 (64%) developed cataracts, 33 (20%) developed increased intraocular pressure, 76 (46%) eyes developed band keratopathy, posterior synechiae were present in 96 (58%) eyes. Among 89 children 73% were on immunomodulators, and 40% were treated with non–steroidal anti–inflammatory agents alone or in combination with immunomodulators, and 21% were treated with topical and/or systemic steroids. Among 65 children who required immunomodulation, only one chemotherapeutic agent was used in 30 children, two agents in 21 children, and three or more in 14 children. Visual acuities of 89 children were documented and compared at standard intervals. By mixed models linear regression, visual acuity improved an average of 0.0113 logMAR units at each two–month visit (p=0.032). Conclusions: In spite of the severity of JIA–associated uveitis, much of the children’s vision can be preserved if the patients are treated appropriately.

Keywords: autoimmune disease • clinical (human) or epidemiologic studies: outcomes/complications • infant vision