Background JIA-associated uveitis is an important cause of ocular morbidity overtime.
Objectives To evaluate the risk factors of uveitis development and describe its characteristics and outcome in a cohort of Greek adult patients with JIA. No relevant Greek data have been published so far.
Methods Medical charts were reviewed in terms of gender, current age, ILAR category, age and ANA titer at disease onset. For patients with an established uveitis, the type of uveitis, date of diagnosis, uveitis complications (synechiae, cataract, glaucoma) were also recorded. The final ocular outcome was the Best Corrected Visual Acuity (BCVA) at the last follow up visit and was ranked in 3 levels: a) good visual acuity: BCVA ≥20/40, b) impaired visual acuity: BCVA 20/50–20/100, c) legal blindness: BCVA ≤20/200.
Results A total of 102 (72 females) patients were enrolled with a disease age of onset (mean ±SD) 7.7±4 years, a disease course 17.2±6.7 years and patients' current age 25±5.9 years. The JIA subtypes were systemic (12.7%), oligoarthritis (29.4%), polyarthritis (29.4%, 10.8% RF positive), psoriatic (8.8%), enthesitis-related arthritis (17.6%) and unclassified arthritis (1.9%). Uveitis developed in 11 patients (10.8%), mainly in females (10/11 females, p=0.224). In 90.9% of the patients, uveitis was diagnosed within the first 3.5 years of the disease (mean time 2.2, range 0–13 years). In none of these patients uveitis was diagnosed prior to JIA, while in only one, concurrently. Uveitis was mainly bilateral than unilateral (81.8% vs 18.2%). Patients with oligoarticular type of onset had the highest rate of uveitis (9/30, 30%). Patients with uveitis were significantly younger at onset than those free of uveitis (p<0.001) and had a higher rate of ANA positivity (81.8% vs 27.3%, p=0.001). Five of these 11 patients (45.5%, 4.9% of the cohort) developed at least one ophthalmologic complication. Cataract was detected in 4/11 patients (36.3%), synechiae in 4/11 (36.3%) and glaucoma in 4/11 patients (36.3%). Three of the 11 (27.3%) developed all the aforementioned complications. The visual outcome at the study visit revealed unilateral legal blindness in 18.2% and the rest (81.8%) had a bilateral good visual acuity. Predictors of uveitis development were early disease onset [OR (95%) 0.562 (0.381, 0.829), p=0.004] and ANA positivity at onset [OR (95%) 10.703 (1.821, 62.899), p=0.009]. Oligoarticular onset was positively associated with uveitis development only in the univariate analysis (p=0.01).
Conclusions The majority of adults with JIA-associated uveitis had a good visual bilateral acuity after a -17 year disease onset. ANA positivity and younger age at disease presentation have been proved to be independent risk factors for uveitis development in Greek patients, too.
Saurenmann et al (2007). Arthritis Rheum. 56:647–57.
Disclosure of Interest None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.