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Abstract #46711 Published in IGR 13-3
Prevalence of ocular manifestations in patients with juvenile idiopathic arthritis
Rubio Perez N; De la O Cavazos M; Lopez Salinas A; Diaz Prieto TJournal of Rheumatology 2011; 38: 1194
Introduction: Juvenile Idiopathic Arthritis (JIA) is a heterogeneous group of chronic inflammatory arthropathies of unknown etiology, affecting children under 16 years of age. Chronic anterior uveitis is present on 10 to 30% of the patients with JIA. It is common in girls with oligoarthritis and positive antinuclear antibodies (ANAs). It may be developed during the course of the JIA or be the initial manifestation. It is of insidious onset and sometimes asymptomatic with involvement of one or both eyes. The most frecuent ocular complications are: cataract, secondary glaucoma, band keratopathy and iris synechiae. Objective: Provide information about the presence of uveitis in the Mexican children with JIA, clinical features, ocular manifestations and complications. Methods: This was a longitudinal and retrospective study that included patients with diagnosis of JIA of the Pediatric Rheumatology Clinic of the University Hospital nullJose Eleuterio Gonzaleznull between July 1986 and February 2010. The diagnosis and classification of the disease were made according to the ILAR criteria. The data was obtained through a retrospective review of clinical files. The ophthalmologic evaluation included: best visual acuity corrected and converted to logMAR, external and slit lamp biomicroscopy examination, IOP measurement (tonometry Goldman and / or Perkins), funduscopic examination with indirect ophthalmoscope. We performed a descriptive statistical analysis of the demographic data, the presence of uveitis, complications, serology and treatment. Univariate analysis of variables associated with the development of uveitis and Multivariate analysis with logistic regression system to determine the absolute risk of developing uveitis. Results: We studied 98 patients, mean age of onset of arthritis was 7.4 years, 71(72.4%) girls and 27 (27.5%) boys, (ratio 2.6:1). Oligoarthritis in 44 (44.9%), Polyarthritis 36 (36.8%), Systemic arthritis 16 (16.4%), Undifferentiated arthritis 2 (1.9%). Positive ANA in 53 (55.8%). Treated with biologic therapy 24 (24.48%). Uveitis in 16 (16.3%), mean age of onset was 3 years, 14 (87.5%) girls and 2 (12.5%) boys. Oligoarthritis 12 (75%), Polyarthritis 4 (25%), Systemic arthritis 0 (0%), Undifferentiated arthritis 0 (0%). Bilateral Uveitis in 13 (81.2%) and unilateral in 3 (18.8%). Positive ANA in 12 (80%). Treated with biological therapy on 8 (50%). Eyes with uveitis 29 (90.6%), eyes with complications 16 (55.2%): posterior synechiae 9 (56.2%), band keratopathy 8 (50%), cataract, five (31.2%), glaucoma 5 (31.2 %). Risk of developing uveitis with Oligoarthritis: 4.41 odds ratio (confidence interval: 1.24 to 15.75). Tendency to develop uveitis in patients with positive ANA and at an early age of onset of JIA. Conclusion: Chronic anterior uveitis is the most common extraarticular feature of JIA. We recommend an early diagnosis and a multidisciplinary approach, especially in girls with oligo or polyarthritis of early onset and associated with ANA.
N. Rubio Perez. Hospital Universitario Dr. Jose Eleuterio Gonzalez, Mexico.
Classification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
