Purpose: To describe the frequencies and risk factors of ocular complications and poor visual outcomes in children with juvenile idiopathic arthritis (JIA). Methods: Retrospective cohort study, including 69 consecutive children (116 eyes) affected by JIA-associated uveitis managed at a tertiary uveitis clinic. Results: The incidence of visual loss to the 20/50 or worse threshold was 0.04/eye-year (EY) and to the 20/200 or worse threshold was 0.02/EY. The most common complications at baseline were posterior synechiae (52%), band keratopathy (38%), and cataract (12%). Risk factor for a visual acuity threshold of 20/50 or worse included hypotony (p = 0.01; hazard ratio [HR] 3.7; 95% CI 1.3-10.4); anterior chamber flare >1 (p = 0.04; HR 1.3; 95% CI 0.5-3.4); a positive antinuclear antibody (ANA) (p = 0.02; HR1.4; 95% CI 0.8-2.4). Hypotony and positive ANA are also associated to the 20/200 or worse threshold (p = 0.03; HR 5.1; 95% CI 1.1-23.9 and p = 0.04; HR 1.0; 95% CI 0.4-2.3; respectively). Use of immunosuppressive drugs was associated with a reduced risk of visual loss of 20/200 or worse (odds ratio 0.14, 95% CI, 0.02-1.29; p = 0.04). Conclusions: Loss of vision and ocular complications still occur among children with JIA-related uveitis. Prompt diagnosis and a strict follow up associated to immunosuppressive therapy may decrease the poor visual outcome.

Juvenile idiopathic arthritis associated uveitis at an Italian tertiary referral center: clinical features and complications / Paroli, Maria Pia; Abbouda, Alessandro; Restivo, Lucia; Sapia, A.; Abicca, Irene; Pivetti, Paola. - In: OCULAR IMMUNOLOGY AND INFLAMMATION. - ISSN 0927-3948. - ELETTRONICO. - 1:23(2015), pp. 74-81. [10.3109/09273948.2013.855798]

Juvenile idiopathic arthritis associated uveitis at an Italian tertiary referral center: clinical features and complications

PAROLI, Maria Pia
Primo
;
ABBOUDA, ALESSANDRO
Secondo
;
RESTIVO, LUCIA;ABICCA, IRENE
Penultimo
;
PIVETTI, Paola
Ultimo
2015

Abstract

Purpose: To describe the frequencies and risk factors of ocular complications and poor visual outcomes in children with juvenile idiopathic arthritis (JIA). Methods: Retrospective cohort study, including 69 consecutive children (116 eyes) affected by JIA-associated uveitis managed at a tertiary uveitis clinic. Results: The incidence of visual loss to the 20/50 or worse threshold was 0.04/eye-year (EY) and to the 20/200 or worse threshold was 0.02/EY. The most common complications at baseline were posterior synechiae (52%), band keratopathy (38%), and cataract (12%). Risk factor for a visual acuity threshold of 20/50 or worse included hypotony (p = 0.01; hazard ratio [HR] 3.7; 95% CI 1.3-10.4); anterior chamber flare >1 (p = 0.04; HR 1.3; 95% CI 0.5-3.4); a positive antinuclear antibody (ANA) (p = 0.02; HR1.4; 95% CI 0.8-2.4). Hypotony and positive ANA are also associated to the 20/200 or worse threshold (p = 0.03; HR 5.1; 95% CI 1.1-23.9 and p = 0.04; HR 1.0; 95% CI 0.4-2.3; respectively). Use of immunosuppressive drugs was associated with a reduced risk of visual loss of 20/200 or worse (odds ratio 0.14, 95% CI, 0.02-1.29; p = 0.04). Conclusions: Loss of vision and ocular complications still occur among children with JIA-related uveitis. Prompt diagnosis and a strict follow up associated to immunosuppressive therapy may decrease the poor visual outcome.
2015
children; juvenile Idiopathic arthritis,; ocular complication,; uveitis; visual acuity
01 Pubblicazione su rivista::01a Articolo in rivista
Juvenile idiopathic arthritis associated uveitis at an Italian tertiary referral center: clinical features and complications / Paroli, Maria Pia; Abbouda, Alessandro; Restivo, Lucia; Sapia, A.; Abicca, Irene; Pivetti, Paola. - In: OCULAR IMMUNOLOGY AND INFLAMMATION. - ISSN 0927-3948. - ELETTRONICO. - 1:23(2015), pp. 74-81. [10.3109/09273948.2013.855798]
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