Uveitis screening should start immediately when juvenile idiopathic arthritis (JIA) is suspected or confirmed—and continue for at least eight years after diagnosis, a recent study suggests. The researchers add that timely systemic immunosuppressive treatment in patients at high risk of developing ocular complications can help to maintain control of any ocular inflammation.
This population-based, multicenter, prospective, cross-sectional study followed 434 patients with JIA for 18 years.
A team observed the development of uveitis in 22.1% of patients with JIA, diagnosing 2.8% between eight and 18 years of follow-up. They added that active uveitis was present in 24.4% of patients at the 18-year visit. They noted that systemic immunosuppressive medication was more common among patients with uveitis (49.0%) compared with patients without uveitis (23.1%).
The investigators found ocular complications in 38.8% of patients and discovered that the presence of antinuclear antibodies and a short duration between the onset of JIA and the diagnosis of uveitis were risk factors for developing ocular complications. They noted that patients with a diagnosis of uveitis before the onset of JIA all developed cataract and had an increased risk of developing glaucoma. The added that 8.9% of patients with uveitis had decreased visual acuity and 5.0% patients with JIA and uveitis had binocular decreased visual acuity.
Rypdal V, Glerup M, Songstad NT, et al. Uveitis in juvenile idiopathic arthritis: 18-year outcome in the population-based Nordic cohort study. Ophthalmology. August 28, 2020. [Epub ahead of print].