Abstract
Abstract: :
Purpose: The exquisite sensitivity of laser flare photometry (LFP) to detect subclinical changes in inflammation levels has been well demonstrated. Our aim here was to study the use of LFP in monitoring inflammation quantitatively in our collective of JIA related uveitis. Methods: Charts of patients seen at La Source Eye Center and in the Department of Ophthalmology of La Pitié-Salpétrière Hospital from 1995 to 2001 with the diagnosis of JIA associated uveitis were reviewed. Epidemiological and clinical characteristics were analysed and LFP values at presentation and during follow-up were recorded. LFP was done at each visit, using a Kowa-FM-500 or FC-1000 photometer (Kowa Co, Tokyo Japan) and correlated with clinical evolution and treatment. Mean flare values were compared statistically using Student's t test. Patients were divided into severe cases with a bad visual outcome (VA < 0.2) and benign cases with a maintained visual acuity of 0.3 or better. Results: Thirty-six patients with JIA associated uveitis, 12 severe cases and 24 "benign" cases, were identified. Mean follow-up was 3.5 ± 4.9 years. Mean flare values were high at presentation (189.7 ± 92 ph/ms) in the severe disease group and reduction after maximal therapy was unsactisfactory (121.33 ph/ms ; -30%). For the benign cases mean flare at presentation was less high (110 ± 32 ph/ms) although not statistically significantly lower than for the severe disease group because of the high standard deviations However flare reduction was spectacular and significant (29.1 ± 25.7; -75% ; P< 0.05) with good restitution of blood-aqueous barrier. Conclusion: Laser flare photometry was able to predict the outcome of JIA related uveitis which was deleterious in all patients that had not undergone adequate blood-aqueous barrier restitution after maximal therapy. It was further found to be useful to correctly monitor tapering and obtain minimally effective treatment.
Keywords: 327 autoimmune disease • 437 inflammation • 612 uveitis-clinical/animal model