Chronic Non-infectious Uveitis in Patients with Juvenile Idiopathic Arthritis

Ocul Immunol Inflamm. 2016 Aug;24(4):377-85. doi: 10.3109/09273948.2015.1125509. Epub 2016 Feb 22.

Abstract

Purpose: To describe clinical findings and analyze treatment evolution of chronic, non-infectious uveitis in patients with juvenile idiopathic arthritis (JIA).

Methods: A total of 82 patients (147 eyes) with JIA-related uveitis treated for ≥2 months were included (78% females; 79% bilateral uveitis; 74% anterior uveitis). Outcome measures were visual acuity (VA), inflammation control, side-effects, and surgical procedures.

Results: Mean ± SD age at diagnosis was 4.9 ± 3.8 years; mean ± SD follow-up time was 8.7 ± 7.8 years. Mean VA did not significantly change throughout the study. Three (2%) eyes resulted in no light perception (NLP) vision. Thirty (37%) patients underwent 69 procedures. In total, 41 (50%) patients achieved inflammation control. TNF-α inhibitors were significantly associated with inflammation control. Seven (8.5%) patients stopped treatment due to side-effects.

Conclusions: JIA is a cause of significant ocular morbidity. TNF-α inhibitor use was associated with inflammation control. Prospective, randomized, double blind clinical trials in this regard are warranted.

Keywords: Immunomodulation; inflammation; juvenile idiopathic arthritis; uveitis.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Arthritis, Juvenile / complications*
  • Arthritis, Juvenile / diagnosis
  • Arthritis, Juvenile / drug therapy
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Methotrexate / therapeutic use
  • Retrospective Studies
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / drug therapy
  • Uveitis, Anterior / etiology*
  • Visual Acuity / physiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Immunosuppressive Agents
  • Tumor Necrosis Factor-alpha
  • Methotrexate