Uveitis in Juvenile Idiopathic Arthritis 18-Year Outcome in the Population-based Nordic Cohort Study

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Nordic Study Grp Pediat Rheumatolo , Rypdal , V , Glerup , M , Songstad , N T , Aalto , K & Leinonen , S 2021 , ' Uveitis in Juvenile Idiopathic Arthritis 18-Year Outcome in the Population-based Nordic Cohort Study ' , Ophthalmology , vol. 128 , no. 4 , pp. 598-608 . https://doi.org/10.1016/j.ophtha.2020.08.024

Title: Uveitis in Juvenile Idiopathic Arthritis 18-Year Outcome in the Population-based Nordic Cohort Study
Author: Nordic Study Grp Pediat Rheumatolo; Rypdal, Veronika; Glerup, Mia; Songstad, Nils Thomas; Aalto, Kristiina; Leinonen, Sanna
Other contributor: University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Head and Neck Center





Date: 2021-04
Language: eng
Number of pages: 11
Belongs to series: Ophthalmology
ISSN: 0161-6420
DOI: https://doi.org/10.1016/j.ophtha.2020.08.024
URI: http://hdl.handle.net/10138/330803
Abstract: Purpose: To assess the long-term outcome of uveitis in juvenile idiopathic arthritis (JIA). Design: Population-based, multicenter, prospective JIA cohort, with a cross-sectional assessment of JIA-associated uveitis (JIA-U) 18 years after the onset of JIA. Participants: A total of 434 patients with JIA, of whom 96 had uveitis, from defined geographic areas of Denmark, Finland, Norway, and Sweden. Methods: Patients with onset of JIA between January 1997 and June 2000 were prospectively followed for 18 years. Pediatric rheumatologists and ophthalmologists collected clinical and laboratory data. Main Outcome Measures: Cumulative incidence of uveitis and clinical characteristics, JIA and uveitis disease activity, ocular complications, visual outcome, and risk factors associated with the development of uveitis-related complications. Results: Uveitis developed in 96 (22.1%) of 434 patients with JIA. In 12 patients (2.8%), uveitis was diagnosed between 8 and 18 years of follow-up. Systemic immunosuppressive medication was more common among patients with uveitis (47/96 [49.0%]) compared with patients without uveitis (78/338 [23.1 %]). Active uveitis was present in 19 of 78 patients (24.4%) at the 18-year visit. Ocular complications occurred in 31 of 80 patients (38.8%). Short duration between the onset of JIA and the diagnosis of uveitis was a risk factor for developing ocular complications (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8). Patients with a diagnosis of uveitis before the onset of JIA all developed cataract and had an OR for development of glaucoma of 31.5 (95% CI, 3.6-274). Presence of antinuclear antibodies (ANAs) was also a risk factor for developing 1 or more ocular complications (OR, 3.0; 95% CI, 1.2-7.7). Decreased visual acuity (VA) Conclusions: Our results suggest that uveitis screening should start immediately when the diagnosis of JIA is suspected or confirmed and be continued for more than 8 years after the diagnosis of JIA. Timely systemic immunosuppressive treatment in patients with a high risk of developing ocular complications must be considered early in the disease course to gain rapid control of ocular inflammation. (C) 2020 by the American Academy of Ophthalmology.
Subject: uveitis
juvenile idiopathic arthritis
long-term outcome
prospective
population-based
uveitis cumulative incidence
SUN criteria
ocular complications
risk factors for ocular complications
disease activity
treatment
3125 Otorhinolaryngology, ophthalmology
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