Recent advances in uveitis of juvenile idiopathic arthritis

Chronic scarring-type uveitis is a frequent extra-articular manifestation of juvenile idiopathic arthritis. It occurs in about 20% of children with this disease, commencing typically within a few years from its onset. The risk of uveitis is greatest in antinuclear antibody-positive girls with early...

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Bibliographic Details
Published in:Survey of Ophthalmology 2003-09, Vol.48 (5), p.489-502
Main Authors: Kotaniemi, Kaisu, Savolainen, Anneli, Karma, Anni, Aho, Kimmo
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents - therapeutic use
Arthritis, Juvenile - complications
Biological and medical sciences
Child
Child, Preschool
epidemiology
Female
Humans
Immunosuppressive Agents - therapeutic use
Infant
juvenile chronic arthritis
juvenile idiopathic arthritis
juvenile rheumatoid arthritis
Male
Medical sciences
Mydriatics - therapeutic use
Ophthalmology
Retinopathies
Risk Factors
Uvea diseases
uveitis
Uveitis - etiology
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Summary:Chronic scarring-type uveitis is a frequent extra-articular manifestation of juvenile idiopathic arthritis. It occurs in about 20% of children with this disease, commencing typically within a few years from its onset. The risk of uveitis is greatest in antinuclear antibody-positive girls with early onset oligoarthritis. The classic clinical picture is chronic bilateral anterior uveitis, usually asymptomatic until substantial damage to intraocular structures occurs. In view of the asymptomatic nature of the condition, routine screening of juvenile idiopathic arthritis patients 2–4 times a year is crucial to prevent complications. The treatment consists of topical corticosteroids and mydriatics, in severe cases with immunosuppressive agents, and surgical management of complications. Although the prognosis of uveitis is improving, there are cases refractory to standard regimens. Patients in whom uveitis commences prior to the onset of arthritis present a special problem.
ISSN:0039-6257
1879-3304
DOI:10.1016/S0039-6257(03)00084-5