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A practical approach to uveitis screening in children with juvenile idiopathic arthritis
  1. Ivan Foeldvari1,
  2. Marcela Bohn2,3,
  3. Harry Petrushkin2,4,
  4. S Angeles Han5,
  5. Regitze Bangsgaard6,
  6. Joan Calzada-Hernández7,
  7. Tamas Constantin8,
  8. Joke H de Boer9,
  9. Jesus Díaz-Cascajosa10,
  10. Clive Edelsten11,
  11. Mia Glerup12,
  12. Helene Ingels13,
  13. Sebastian Kramer14,
  14. Elisabetta Miserocchi15,
  15. Ellen Nordal16,
  16. Rotraud K Saurenmann17,18,
  17. Gabriele Simonini19,
  18. Ameenat Lola Solebo20,
  19. Jan Titz14,
  20. Jordi Anton7
  1. 1Hamburg Centre for Pediatric and Adolescence Rheumatology, Hamburg, Germany
  2. 2Moorfields Eye Hospital NHS Foundation Trust, London, UK
  3. 3West Hertfordshire Teaching Hospitals NHS Foundation Trust, London, UK
  4. 4Great Ormond Street Hospital NHS Foundation Trust, London, UK
  5. 5University of Cincinnati, Cincinnati, Ohio, USA
  6. 6Department of Ophthalmology, Copenhagen University Hospital Glostrup/Rigshospitalet, Copenhagen, Denmark
  7. 7Universitat de Barcelona, Barcelona, Spain
  8. 8Semmelweis University, Budapest, Hungary
  9. 9Ophthalmology, F.C. Donders Institute, Utrecht, The Netherlands
  10. 10Ophthalmology Department, Universidad de Barcelona, Barcelona, Spain
  11. 11Ophthalmology, Ipswich Hospital, Ipswich, UK
  12. 12Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
  13. 13Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Kobenhavn, Denmark
  14. 14Patients Representative, Hamburg, Germany
  15. 15Ophthalmology, San Raffaele Scientific Institute, milano, Italy
  16. 16Department of Paediatrics, UiT The Arctic University of Norway, Tromso, Norway
  17. 17Department of Paediatrics, Kantonsspital Winterthur, Winterthur, Switzerland
  18. 18Department of Rheumatology, University Children's Hospital Zurich, Zurich, Switzerland
  19. 19Meyer Children's Hospital IRCCS, Florence, Italy
  20. 20MRC Centre of Epidemiology of Child Health, Institute of Child Health University College London, London, UK
  1. Correspondence to Dr Ivan Foeldvari, Hamburg Centre for Pediatric and Adolescence Rheumatology, Hamburg, Germany; foeldvari{at}t-online.de

Abstract

Background Juvenile idiopathic arthritis (JIA)-associated uveitis typically presents as a silent chronic anterior uveitis and can lead to blindness. Adherence to current screening guidelines is hampered by complex protocols which rely on the knowledge of specific JIA characteristics. The Multinational Interdisciplinary Working Group for Uveitis in Childhood identified the need to simplify screening to enable local eye care professionals (ECPs), who carry the main burden, to screen children with JIA appropriately and with confidence.

Methods A consensus meeting took place in January 2023 in Barcelona, Spain, with an expert panel of 10 paediatric rheumatologists and 5 ophthalmologists with expertise in paediatric uveitis. A summary of the current evidence for JIA screening was presented. A nominal group technique was used to reach consensus.

Results The need for a practical but safe approach that allows early uveitis detection was identified by the panel. Three screening recommendations were proposed and approved by the voting members. They represent a standardised approach to JIA screening taking into account the patient’s age at the onset of JIA to determine the screening interval until adulthood.

Conclusion By removing the need for the knowledge of JIA categories, antinuclear antibody positivity or treatment status, the recommendations can be more easily implemented by local ECP, where limited information is available. It would improve the standard of care on the local level significantly. The proposed protocol is less tailored to the individual than the ‘gold standard’ ones it references and does not aim to substitute those where they are being used with confidence.

  • Not applicable

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

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Footnotes

  • IF and MB are joint first authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests IF, MB and HP: no competing interest. SAH is supported by the National Institutes for Health (NIH) National Eye Institute under Award Numbers R01EY030521 and R01 EY034565. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the views or policies of the Department of Health and Human Services, nor does the mention of trade names, commercial products or organisations imply endorsement by the US government. RB, JC-H, TC, JHdB, JD-C, CE, MG, HI, SK, EM, EN, RKS, GS, ALS, JT and JA: no competing interest.

  • Provenance and peer review Not commissioned; externally peer reviewed.