Objectives To determine the frequency of uveitis and its complications in patients with juvenile idiopathic arthritis (JIA).
Methods A retrospective analysis of 185 patients with JIA diagnosed between 1980 ? 1995 followed in 2 paediatric rheumatology centres. Patients with chronic and acute uveitis were identified in subgroups of JIA.
Results Uveitis was diagnosed in 24 (13.0%) patients. Sixteen (8.6%) patients had chronic and eight (4.3%) had acute uveitis. Twelve (75.0%) patients who developed chronic uveitis did so after the onset of arthritis, but only 8 within the first 7 years of JIA. There were four patients who developed chronic uveitis 9, 13, 14 and 17 years after JIA onset. Four patients who manifested arthritis after uveitis did so after 1, 3, 3 and 6 years. Chronic uveitis was associated with systemic arthritis (in 17.6%), persistent oligoarthritis (in 29.6%), extended oligoarthritis (in 4,5%), psoriatic arthritis (in 40%) and other arthritis (in 14.3%). Complications, such as synechiae, band keratopathy, cataract or glaucoma developed in 10 (62.5%) patients with chronic uveitis. As expected, these were found mainly in patients with ANA positivity (n = 8; 80.0%), in contrast to only 2 between ANA negative patients. Amaurosis was found in 7 patients; complete visual loss developed in one case.
Acute uveitis was seen only among arthritis+enthesitis patients (n = 6; 10.7%) and in patients with other arthritis (n = 2; 14,3%).
Conclusion Uveitis is relatively common in JIA. Chronic form may occur in several JIA subgroups, with persistent oligoarthritis patients and, surprisingly, with psoriatic arthritis patients being the most frequently affected. Acute uveitis is associated with HLA B27 associated disease forms. It is important to check for asymptomatic uveitis through the entire course of disease, as it may begin well after the onset of arthritis and may lead to severe complications.
Supported by grant NE/4879–3 from IGA of the Czech Ministry of Health.
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