Incidence and outcomes of uveitis in juvenile rheumatoid arthritis, a synthesis of the literature

Abstract

The cumulative incidence of uveitis in JRA varies according to geographic location, presence of ANA, type of JRA onset and gender. Uveitis, adverse visual outcome, and complications in JRA are less frequent than commonly accepted.

Proposed outcome measures for prospective clinical trials in juvenile idiopathic arthritis–associated uveitis: A consensus effort from the multinational interdisciplinary working group for uveitis in childhood

“…Juvenile idiopathic arthritis (JIA) is the most common extraocular disease associated with pediatric uveitis (1). The prevalence of JIA is 50 -200 per 100,000 children (2,3), and in 10 -18% of patients, arthritis is accompanied by uveitis (3)(4)(5).…”

Limited value of cyclosporine A for the treatment of patients with uveitis associated with juvenile idiopathic arthritis

“…[1][2][3] The prevalence of uveitis in juvenile arthritis varies geographically, showing rates of between 10 and 18% in the United states of America and Scandinavia 4 and 12% in Germany. 5 Complications develop frequently, at rates of 25-50% in patients with JIA-associated uveitis.…”

Importance of recognizing and preventing blindness from juvenile idiopathic arthritis–associated uveitis

“…Also problematic is that these data are at times refuted by other studies, as in the aforementioned meta-analysis reporting that adverse visual outcomes (acuity worse than 20/40) were less than previously reported (20). These claims are misleading, however, since this study did not account for visual acuity between the patients' individual eyes, which is important considering the tremendous advantage of proper stereoscopic vision, which requires good acuity in both eyes; several of the reviewed series were reported by nonophthalmologists.…”

“…Established screening guidelines categorize high-risk patients as having oligoarticular, seronegative polyarticular, psoriatic, or other arthritis onset prior to age 7 years with positive antinuclear antibody (ANA) testing and a disease duration under 5 years; it is recommended that these patients be screened at 3-month intervals in the absence of previously diagnosed uveitis (10). A meta-analysis of case series of patients with JIA between 1980 and 2004 (20) found ANAnegative oligoarticular patients have the same risk of developing uveitis as ANA-positive polyarticular patients, and the authors recommend consistency between screening times for these groups (currently 6 months and 3 months, respectively). Rheumatoid factor negativity is typ-ical (21) and antihistone antibodies are receiving more attention as possible biomarkers for disease chronicity and severity risk (22).…”