Uveitis and juvenile idiopathic arthritis: A cohort study

February 11, 2008

Clinical Ophthalmology Issue:2007, Volume 1 Issue 4

BenEzra1, e Cohen1, Francine Behar-Cohen2

1Hadassah University Hospital, Jerusalem, Israel; 2Hotel Dieu Hospital and

U598 INSERM Paris, France

Objective: Assess the incidence of intraocular inflammation (uveitis) and

ocular complications in children with various types of JIA in a single

cohort of patients.

Patients: Included are 172 children (35 boys and 137 girls) diagnosed with

JIA. All underwent thorough initial ophthalmologic examination and were

followed for a minimum of 3 years.

Results: Of 172 children with JIA, 152 (88.4%) presented with arthritis.

Uveitis was detected in 14 of the152 children (9.2%) during the first

ophthalmic examination. In 17 additional patients of this group (11.2%),

uveitis developed during the follow up period of up to 15 years. Twenty

children out of the total of 172 (11.6%) presented initially with uveitis.

In children developing uveitis before or along with arthritic

manifestations, the ocular disease was chronic with a high rate of secondary

complications (band keratopathy, glaucoma, posterior synechiae and

cataract).

In all affected eyes the initial ocular inflammation was typically confined

to the anterior segment. On longer follow up however, most children

developed binocular disease and posterior segment involvement. Dense

cataract and amblyopia were the major cause of severe visual disabilities.

Conclusion: Pauciarticular JIA is associated with intraocular inflammation

(uveitis) early during the arthritic disease course. The ocular disease

course is unpredictable. Therefore education of parents regarding its signs

and symptoms is of utmost importance. To preserve functional vision,

secondary ocular complications and amblyopia should be avoided.

Keywords: arthritis, eye, JIA, uveitis, intraocular inflammation, visual

acuity, cataract, glaucoma

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