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Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss.
Am J Ophthalmol. 2007 May; 143(5):840-846.AJ

Abstract

PURPOSE

To estimate the incidences of ocular complications and vision loss in patients with juvenile idiopathic arthritis (JIA)-associated uveitis, to describe risk factors for vision loss, and to describe the association between therapy and complications and vision loss.

DESIGN

Retrospective cohort study.

METHODS

setting: Single-center, academic practice. study population: A total of 75 patients with JIA-associated uveitis evaluated between July 1984 and August 2005. procedures: Clinical data on these patients were analyzed. outcome measures: Occurrence of ocular complications and visions of 20/50 or worse and 20/200 or worse.

RESULTS

Over a median follow-up of three years, the incidence of any ocular complication was 0.33/eye-year (EY). Rates of vision loss to 20/50 or worse and 20/200 or worse were 0.10/EY and 0.08/EY, respectively. Risk factors at presentation for incident vision loss included presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal intraocular pressure (IOP). During follow-up, ocular inflammation > or = 0.5+ cells was associated with an increased risk of visual impairment (relative risk [RR] = 2.02, P = .006) and of blindness (RR = 2.99, P = .03). Immunosuppressive drug therapy reduced the risk of hypotony by 74% (P = .002), epiretinal membrane formation by 86% (P = .05), and blindness in the better eye by 60% (P = .04).

CONCLUSIONS

Incident vision loss and complications were common. Presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal IOP at presentation were associated with vision loss during follow-up. Use of immunosuppressive drugs reduced the risk of some ocular complications and of blindness in the better-seeing eye.

Authors+Show Affiliations

Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. jthorne@jhmi.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17362866

Citation

Thorne, Jennifer E., et al. "Juvenile Idiopathic Arthritis-associated Uveitis: Incidence of Ocular Complications and Visual Acuity Loss." American Journal of Ophthalmology, vol. 143, no. 5, 2007, pp. 840-846.
Thorne JE, Woreta F, Kedhar SR, et al. Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss. Am J Ophthalmol. 2007;143(5):840-846.
Thorne, J. E., Woreta, F., Kedhar, S. R., Dunn, J. P., & Jabs, D. A. (2007). Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss. American Journal of Ophthalmology, 143(5), 840-846.
Thorne JE, et al. Juvenile Idiopathic Arthritis-associated Uveitis: Incidence of Ocular Complications and Visual Acuity Loss. Am J Ophthalmol. 2007;143(5):840-846. PubMed PMID: 17362866.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Juvenile idiopathic arthritis-associated uveitis: incidence of ocular complications and visual acuity loss. AU - Thorne,Jennifer E, AU - Woreta,Fasika, AU - Kedhar,Sanjay R, AU - Dunn,James P, AU - Jabs,Douglas A, Y1 - 2007/03/23/ PY - 2006/11/20/received PY - 2007/01/06/revised PY - 2007/01/12/accepted PY - 2007/3/17/pubmed PY - 2007/6/15/medline PY - 2007/3/17/entrez SP - 840 EP - 846 JF - American journal of ophthalmology JO - Am J Ophthalmol VL - 143 IS - 5 N2 - PURPOSE: To estimate the incidences of ocular complications and vision loss in patients with juvenile idiopathic arthritis (JIA)-associated uveitis, to describe risk factors for vision loss, and to describe the association between therapy and complications and vision loss. DESIGN: Retrospective cohort study. METHODS: setting: Single-center, academic practice. study population: A total of 75 patients with JIA-associated uveitis evaluated between July 1984 and August 2005. procedures: Clinical data on these patients were analyzed. outcome measures: Occurrence of ocular complications and visions of 20/50 or worse and 20/200 or worse. RESULTS: Over a median follow-up of three years, the incidence of any ocular complication was 0.33/eye-year (EY). Rates of vision loss to 20/50 or worse and 20/200 or worse were 0.10/EY and 0.08/EY, respectively. Risk factors at presentation for incident vision loss included presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal intraocular pressure (IOP). During follow-up, ocular inflammation > or = 0.5+ cells was associated with an increased risk of visual impairment (relative risk [RR] = 2.02, P = .006) and of blindness (RR = 2.99, P = .03). Immunosuppressive drug therapy reduced the risk of hypotony by 74% (P = .002), epiretinal membrane formation by 86% (P = .05), and blindness in the better eye by 60% (P = .04). CONCLUSIONS: Incident vision loss and complications were common. Presence of posterior synechiae, anterior chamber flare > or = 1+, and abnormal IOP at presentation were associated with vision loss during follow-up. Use of immunosuppressive drugs reduced the risk of some ocular complications and of blindness in the better-seeing eye. SN - 0002-9394 UR - https://www.unboundmedicine.com/medline/citation/17362866/Juvenile_idiopathic_arthritis_associated_uveitis:_incidence_of_ocular_complications_and_visual_acuity_loss_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(07)00103-1 DB - PRIME DP - Unbound Medicine ER -