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Ocular manifestations of juvenile rheumatoid arthritis.
Am J Ophthalmol. 1975 Jun; 79(6):1026-33.AJ

Abstract

We followed 210 cases of juvenile rheumatoid arthritis closely for eleven years. Thirty-six of the 210 patients (17.2%) developed iridocyclitis. Iridocyclitis was seen most frequently in young female patients (0 to 4 years) with the monoarticular or pauciatricular form of the arthritis. However, 30% of the patients developed uveitis after 16 years of age. Although 61% of patients had a noncontributory ocular history on entry, 42% had active uveitis on entry. Our approach was effective in detecting uveitis in new cases and exacerbations of uveitis in established cases. Forty-four percent of patients with uveitis had one or more identifiable signs or symptoms, such as red eye, ocular pain, decreased visual acuity, or photophobia, in order of decreasing frequency. Even after early detection and prompt treatment, 41% of cases of uveitis did not respond to more than six months of intensive topical treatment with corticosteroids and mydriatics. Despite this, there was a dramatic decrease in the 50% incidence of blinding complications of uveitis cited in earlier studies. Cataract and band keratopathy occurred in only 22 and 13% of our group, respectively. We used chloroquine or hydroxychloroquine in 173 of 210 cases and found only one case of chorioretinopathy attributable to these drugs. Systemically administered corticosteroids were used in 75 of 210 cases; a significant number of posterior subcapsular cataracts was found. Typical keratoconjunctivitis sicca developed in three of the uveitis cases. This association with uveitis and JRA was not noted previously. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

1079693

Citation

Chylack, L T., et al. "Ocular Manifestations of Juvenile Rheumatoid Arthritis." American Journal of Ophthalmology, vol. 79, no. 6, 1975, pp. 1026-33.
Chylack LT, Bienfang DC, Bellows AR, et al. Ocular manifestations of juvenile rheumatoid arthritis. Am J Ophthalmol. 1975;79(6):1026-33.
Chylack, L. T., Bienfang, D. C., Bellows, A. R., & Stillman, J. S. (1975). Ocular manifestations of juvenile rheumatoid arthritis. American Journal of Ophthalmology, 79(6), 1026-33.
Chylack LT, et al. Ocular Manifestations of Juvenile Rheumatoid Arthritis. Am J Ophthalmol. 1975;79(6):1026-33. PubMed PMID: 1079693.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular manifestations of juvenile rheumatoid arthritis. AU - Chylack,L T,Jr AU - Bienfang,D C, AU - Bellows,A R, AU - Stillman,J S, PY - 1975/6/11/pubmed PY - 2001/3/28/medline PY - 1975/6/11/entrez SP - 1026 EP - 33 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 79 IS - 6 N2 - We followed 210 cases of juvenile rheumatoid arthritis closely for eleven years. Thirty-six of the 210 patients (17.2%) developed iridocyclitis. Iridocyclitis was seen most frequently in young female patients (0 to 4 years) with the monoarticular or pauciatricular form of the arthritis. However, 30% of the patients developed uveitis after 16 years of age. Although 61% of patients had a noncontributory ocular history on entry, 42% had active uveitis on entry. Our approach was effective in detecting uveitis in new cases and exacerbations of uveitis in established cases. Forty-four percent of patients with uveitis had one or more identifiable signs or symptoms, such as red eye, ocular pain, decreased visual acuity, or photophobia, in order of decreasing frequency. Even after early detection and prompt treatment, 41% of cases of uveitis did not respond to more than six months of intensive topical treatment with corticosteroids and mydriatics. Despite this, there was a dramatic decrease in the 50% incidence of blinding complications of uveitis cited in earlier studies. Cataract and band keratopathy occurred in only 22 and 13% of our group, respectively. We used chloroquine or hydroxychloroquine in 173 of 210 cases and found only one case of chorioretinopathy attributable to these drugs. Systemically administered corticosteroids were used in 75 of 210 cases; a significant number of posterior subcapsular cataracts was found. Typical keratoconjunctivitis sicca developed in three of the uveitis cases. This association with uveitis and JRA was not noted previously. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/1079693/Ocular_manifestations_of_juvenile_rheumatoid_arthritis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9394(75)90689-3 DB - PRIME DP - Unbound Medicine ER -