Uveitis associated with juvenile idiopathic arthritis (JIA) and JIA-like uveitis in pediatric patients.

Abstract

Aims:  To evaluate the prevalence of uveitis and ocular complications in children with juvenile idiopathic arthritis (JIA) and "JIA-like" form. To determine the onset of ocular symptoms in relation to the diagnosis of the underlying disease and identify the most common predictive factor preceding the onset of uveitis.

Materials and methods:  Retrospective analysis of medical records of children with JIA and JIA-like uveitis monitored at the Pediatric Rheumatology and Ophthalmology Clinic at the University Hospital Ostrava between 2016-2024. Observed parameters included the child's age at the time of diagnosis of JIA or JIA-like uveitis, laboratory tests, ocular findings, age at the onset of uveitis symptoms, time correlation with the diagnosis of the underlying disease, ocular complications of recurrent uveitis attacks and overall treatment of the underlying disease.

Results:  There were 27 children in the group with confirmed JIA, with an average age of 5 years. Ten patients were diagnosed with anterior or posterior uveitis. The average age at the time of JIA diagnosis was 6 years. The mean time interval from JIA diagnosis to the appearance of pathological ocular findings was 38 months. Ocular complications were recorded in 50% of children, most commonly cataracts (40%). All children with uveitis were laboratory positive for ANA antibodies. There were 8 patients with JIA-like uveitis, with an average age of 9 years. All children showed signs of anterior or posterior uveitis, which was manifested on average at 8.5 years of age. Exclusion of JIA diagnosis was established on average 6 months after the appearance of ocular pathology. Ocular complications were observed in 88% of children, most frequently posterior synechiae (63%). Laboratory findings showed ANA antibody positivity in 88% of children with uveitis.

Conclusion:  Regular ophthalmological examinations in JIA patients are essential due to the potential occurrence of complications, which are more frequent in young females with JIA-like uveitis and ANA antibody positivity.