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Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood
BACKGROUND: Typically juvenile idiopathic arthritis (JIA)-associated uveitis (further referred as ‘JIA-uveitis’) has its onset in childhood, but some patients suffer its, sometimes visual threatening, complications or ongoing disease activity in adulthood. The objective of this study was to analyze...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056754/ https://www.ncbi.nlm.nih.gov/pubmed/27723840 http://dx.doi.org/10.1371/journal.pone.0164312 |
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author | Haasnoot, Anne-Mieke J. W. Vernie, Lenneke A. Rothova, Aniki v. d. Doe, Patricia Los, Leonoor I. Schalij-Delfos, Nicoline E. de Boer, Joke H. |
author_facet | Haasnoot, Anne-Mieke J. W. Vernie, Lenneke A. Rothova, Aniki v. d. Doe, Patricia Los, Leonoor I. Schalij-Delfos, Nicoline E. de Boer, Joke H. |
author_sort | Haasnoot, Anne-Mieke J. W. |
collection | PubMed |
description | BACKGROUND: Typically juvenile idiopathic arthritis (JIA)-associated uveitis (further referred as ‘JIA-uveitis’) has its onset in childhood, but some patients suffer its, sometimes visual threatening, complications or ongoing disease activity in adulthood. The objective of this study was to analyze uveitis activity, complications and visual prognosis in adulthood. METHODS: In this multicenter study, 67 adult patients (129 affected eyes) with JIA-uveitis were retrospectively studied for best corrected visual acuity, visual fields, uveitis activity, topical/systemic treatments, ocular complications, and ocular surgeries during their 18(th), 22(nd) and 30(th) year of life. Because treatment strategies changed after the year 1990, outcomes were stratified for onset of uveitis before and after 1990. RESULTS: Sixty-two of all 67 included patients (93%) had bilateral uveitis. During their 18(th) life year, 4/52 patients (8%) had complete remission, 28/52 (54%) had uveitis activity and 37/51 patients (73%) were on systemic immunomodulatory treatment. Bilateral visual impairment or legal blindness occurred in 2/51 patients (4%); unilateral visual impairment or legal blindness occurred in 17/51 patients (33%) aged 18 years. The visual prognosis appeared to be slightly better for patients with uveitis onset after the year 1990 (for uveitis onset before 1990 (n = 7) four patients (58%) and for uveitis onset after 1990 (n = 44) 13 patients (30%) were either visual impaired or blind). At least one ocular surgery was performed in 10/24 patients (42%) between their 18(th) and 22(nd) year of life. CONCLUSIONS: Bilateral visual outcome in early adulthood in patients with JIA-uveitis appears to be fairly good, although one third of the patients developed one visually impaired or blind eye. However, a fair amount of the patients suffered from ongoing uveitis activity and needed ongoing treatment as well as surgical interventions. Awareness of these findings is important for ophthalmologists and rheumatologists treating patients with JIA-uveitis, as well as for the patients themselves. |
format | Online Article Text |
id | pubmed-5056754 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-50567542016-10-27 Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood Haasnoot, Anne-Mieke J. W. Vernie, Lenneke A. Rothova, Aniki v. d. Doe, Patricia Los, Leonoor I. Schalij-Delfos, Nicoline E. de Boer, Joke H. PLoS One Research Article BACKGROUND: Typically juvenile idiopathic arthritis (JIA)-associated uveitis (further referred as ‘JIA-uveitis’) has its onset in childhood, but some patients suffer its, sometimes visual threatening, complications or ongoing disease activity in adulthood. The objective of this study was to analyze uveitis activity, complications and visual prognosis in adulthood. METHODS: In this multicenter study, 67 adult patients (129 affected eyes) with JIA-uveitis were retrospectively studied for best corrected visual acuity, visual fields, uveitis activity, topical/systemic treatments, ocular complications, and ocular surgeries during their 18(th), 22(nd) and 30(th) year of life. Because treatment strategies changed after the year 1990, outcomes were stratified for onset of uveitis before and after 1990. RESULTS: Sixty-two of all 67 included patients (93%) had bilateral uveitis. During their 18(th) life year, 4/52 patients (8%) had complete remission, 28/52 (54%) had uveitis activity and 37/51 patients (73%) were on systemic immunomodulatory treatment. Bilateral visual impairment or legal blindness occurred in 2/51 patients (4%); unilateral visual impairment or legal blindness occurred in 17/51 patients (33%) aged 18 years. The visual prognosis appeared to be slightly better for patients with uveitis onset after the year 1990 (for uveitis onset before 1990 (n = 7) four patients (58%) and for uveitis onset after 1990 (n = 44) 13 patients (30%) were either visual impaired or blind). At least one ocular surgery was performed in 10/24 patients (42%) between their 18(th) and 22(nd) year of life. CONCLUSIONS: Bilateral visual outcome in early adulthood in patients with JIA-uveitis appears to be fairly good, although one third of the patients developed one visually impaired or blind eye. However, a fair amount of the patients suffered from ongoing uveitis activity and needed ongoing treatment as well as surgical interventions. Awareness of these findings is important for ophthalmologists and rheumatologists treating patients with JIA-uveitis, as well as for the patients themselves. Public Library of Science 2016-10-10 /pmc/articles/PMC5056754/ /pubmed/27723840 http://dx.doi.org/10.1371/journal.pone.0164312 Text en © 2016 Haasnoot et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Haasnoot, Anne-Mieke J. W. Vernie, Lenneke A. Rothova, Aniki v. d. Doe, Patricia Los, Leonoor I. Schalij-Delfos, Nicoline E. de Boer, Joke H. Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood |
title | Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood |
title_full | Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood |
title_fullStr | Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood |
title_full_unstemmed | Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood |
title_short | Impact of Juvenile Idiopathic Arthritis Associated Uveitis in Early Adulthood |
title_sort | impact of juvenile idiopathic arthritis associated uveitis in early adulthood |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056754/ https://www.ncbi.nlm.nih.gov/pubmed/27723840 http://dx.doi.org/10.1371/journal.pone.0164312 |
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