[Anterior uveitis and juvenile idiopathic arthritis]

Anterior uveitis is one of the most important extraarticular manifestations of juvenile idiopathic arthritis (JIA). The aim of this study was to describe the frequency of uveitis, complications and ocular surgical procedures, to corroborate risk factors for the development of uveitis and to analyze its evolutive characteristics.

Retrospective review of 132 children diagnosed with JIA in our hospital from 1985 to 2000. Patients presenting anterior uveitis (Tyndall + or recent keratic precipitates) were studied.

Uveitis was detected in 26 of 132 children (19%). All of them presented pauciarticular JIA. The patients received corticosteroid therapy for a mean time of 19.2 months, developing a mean of 4.5 episodes of uveitis. Patients diagnosed with uveitis before or within 1 year from the onset of arthritis required longer treatment (295 months versus 206) and suffered more episodes (73 versus 44) than those with uveitis found later on. Complications (cataract, band keratopathy, glaucoma, macular edema) developed in 27.9% of the affected eyes. Surgery was required in 10 eyes.

The incidence of uveitis in our study is similar to recently reported rates. Female sex, pauciarticular onset, serum antinuclear antibodies (ANA) and early onset of uveitis seem to increase the development of chronic uveitis. Periodic slit-lamp ophthalmologic screenings in high risk patients are recommended (Arch Soc Esp Oftalmol 2003; 78: 561-566).