The clinical course of juvenile idiopathic arthritis-associated uveitis in childhood and puberty
- Maretta Hoeve1,
- Viera Kalinina Ayuso1,
- Nicoline E Schalij-Delfos2,
- Leonoor I Los3,
- Aniki Rothova1,
- Joke H de Boer1
- 1Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
- 2Department of Ophthalmology, University Medical Centre Leiden, Leiden, The Netherlands
- 3Department of Ophthalmology, University Medical Centre Groningen, Groningen, The Netherlands
- Correspondence to Maretta Hoeve, Department of Ophthalmology University Medical Center Utrecht, Postbus 85500, 3508 CX Utrecht, The Netherlands;
Contributors MH: concept and design of the study, data collection, data analysis and interpretation of the data, drafting the article, final approval of the version to be published. VKA: concept and design of the study, data analysis, interpretation of the data, drafting the article, final approval of the version to be published. NES-D: acquisition of data, revising the article critically for important intellectual content, final approval of the version to be published. LIL: data collection, review and approval of the manuscript acquisition of data, revising the article critically for important intellectual content, final approval of the version to be published. AR: conception and design of the study, analysis and interpretation of data, revising the article critically for important intellectual content, final approval of the version to be published. JHB: conception and design of the study, analysis and interpretation of data, drafting the article, final approval of the version to be published.
- Accepted 12 February 2012
- Published Online First 7 March 2012
Aim The long-term course of juvenile idiopathic arthritis (JIA)-associated uveitis is not known yet. This study investigates the course and activity of JIA-associated uveitis in childhood and puberty.
Design Retrospective study of the clinical data of 62 JIA patients with uveitis. The main outcome measurements consisted of uveitis activity measured as mean cell grade in the anterior chamber, topical and systemic medication and ocular complications related to disease activity. All data were scored and evaluated per year of age.
Results Uveitis activity took a biphasic course with a quiet phase around the age of 9 years and showed increased activity during early teenage years. The biphasic course was significantly related to age (p=0.048) but not to uveitis duration. More patients were treated with systemic immunosuppressive medication in estimated puberty years (63% in boys, 53% in girls) compared with prepuberty years (46% and 28%, respectively), although the difference was only significant in girls (p<0.001). The presence of cystoid macular oedema and papillitis was not significantly related to estimated puberty, but the development of an hypotonous eye was more frequently observed in boys in estimated puberty years (p=0.026).
Conclusions JIA-associated uveitis appears to take a biphasic course with the second phase of activity during early teenage years and more treatment with systemic immunosuppressive medication occurred during estimated puberty compared with prepuberty years.
- juvenile idiopathic arthritis
- child health (paediatrics)
- intraocular pressure
- treatment surgery
Competing interests None.
Patient consent All patients (and/or parents) treated at UMC Utrecht gave informed consent to their data being used for research goals in advance for previous studies8–9. Patients from different hospitals who did not participate in the previous study gave informed consent for their data to be added to our new study. The medical ethical testing committee of the UMC Utrecht declared that because patients did not need to undergo alternative treatment or change behaviour, this study did not fall under the Dutch law considering medical scientific research (WMO). Patients need to give informed consent when data are directly or indirectly identifiable, which is not the case in our study.
Ethics approval The Medical Ethical Testing committee of the University Medical Centre of Utrecht has waived approval in advance of the study because the study does not fall under the Dutch law WMO, as there are no test persons who have to undergo proceedings or behavioural changes (research proposal nr. 10/311).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Additional data on the use of topical corticosteroids and occurrence of complications per year of age and per year of disease duration are available on request.