Improved Clinical Outcomes In Patients With Juvenile Idiopathic Arthritis Associated Uveitis
Purpose
To analyze the development of ocular complications and visual prognosis in juvenile idiopathic arthritis associate uveitis (JIA-uveitis) compared to the previous decade in the light of new (treatment) guidelines.
Methods
Patients were stratified into two cohorts based on the year of diagnosis of uveitis, before 2010 (n=61) and after 2010 (n=82). Development of ocular complications and visual outcomes were analyzed by univariate and multivariate methods. Treatment with systemic corticosteroids and immunomodifying medication (IMT) were documented.
Results
In total 109 and 133 affected eyes, respectively for cohort 1 (<2010) and cohort 2 (>2010) were included for analysis. In the multivariate analysis with correction for paired eyes, patients in cohort 1 were significantly more at risk for cataract surgery (P=0.03) and secondary glaucoma (P=0.005). Also, the number of eyes that were legally blind and visually impaired at five years follow-up were significantly higher in cohort 1 (7% vs. 2% and 8% vs. 0%, P=0.01, respectively). In cohort 2 both methotrexate and anti-TNF-α therapy were prescribed earlier in the disease course (1.41 vs 0.05 years, P=8.31 x 10-6 and 6.07 vs 1.84 years, P=5.14 × 10-5, respectively).
Conclusion
The visual prognosis of patients with JIA-uveitis diagnosed in the past decennium have improved with less cataract and glaucoma development compared to an earlier cohort. In general these patients are earlier initiated on IMT.
Conflict of interest
No
Authors 1
Last name
WENNINK
Initials of first name(s)
R.W.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 2
Last name
Kalinina Ayuso
Initials of first name(s)
V.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 3
Last name
Pameijer
Initials of first name(s)
E.M.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 4
Last name
Dekkers
Initials of first name(s)
C.C.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 5
Last name
Bozkir
Initials of first name(s)
I.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
Authors 6
Last name
de Boer
Initials of first name(s)
J.H.
Department
Ophthalmology
City
Utrecht
Country
Netherlands
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