Assessing Visual Function and Quality of Life in Children with JIA and JIA-Uveitis Younger than 7 years Old

Abstract

Purpose : Children with juvenile idiopathic arthritis (JIA) aged 7 and younger are at a greatest risk for uveitis. The impact of JIA-associated uveitis (JIA-U) on quality of life (QOL) and visual function of young children is not well characterized. We administered questionnaires in a cross-sectional study to compare visual function and QOL of children ages 2 to 7 with JIA and JIA-U.

Methods : Three validated questionnaires were administered to parents of 51 children, ages 2-7, diagnosed with JIA alone or JIA-U during their regular clinic visits at Cincinnati Children’s Hospital Medical Center and Emory University. The Children’s Visual Function Questionnaire (CVFQ) measures visual function from 0-1 with general health, general vision, competence, personality, family impact, and treatment subscales. The Pediatric Quality of Life Inventory (PedsQL) measures overall QOL from 0-100 with total, physical (e.g. sports), and psychosocial subscales. The Childhood Health Assessment Questionnaire (CHAQ) measures physical function (e.g. activities of daily living) from 0-3. Higher scores indicate better function and QOL in the CVFQ and PedsQL, respectively, but worse function in the CHAQ. Group differences were tested using the Student’s T-Test.

Results : Of 51 children, 38 had JIA alone and 13 had JIA-U (Table 1). They were predominantly white (92%), non-Hispanic (96%), and female (84.%). Oligoarticular was the most common JIA subtype (33%), ANA was positive in 65%, and mean age at JIA diagnosis was 2.4 years (SD 0.99). There were no significant differences in the demographic or clinical characteristics of the groups.

CVFQ general vision and family impact subscales were significantly worse among children with JIA-U compared to those with JIA alone (0.83 vs. 0.93, p=0.013; and 0.83 vs 0.93, p=0.004, respectively). The CHAQ score was worse for children with JIA alone compared to JIA-U (0.38 vs 0.00, p=0.009). There were no significant differences in PedsQL scores.

Conclusions : Young children with JIA-U have worse visual function and impose a larger family burden, but have comparatively less physical limitation with activites of daily living than children with JIA alone. Emotional and labor-intensive burdens on families may be related to social interactions, appointments, and uncertainty of prognosis. Further studies are needed to characterize the impact of uveitis in young children with JIA.

This is a 2021 ARVO Annual Meeting abstract.