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Primed Mycobacterial Uveitis PMU as a Model for Post-Infectious Uveitis
Published on: December 17, 2021
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Juvenile idiopathic arthritis-associated uveitis
1Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK; Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Best Practice & Research. Clinical Rheumatology
|May 19, 2018
Summary
Early screening and treatment of juvenile idiopathic arthritis (JIA)-associated uveitis are crucial for preserving vision. Biologic therapies like adalimumab show promise for patients unresponsive to methotrexate.
Area of Science:
- Ophthalmology
- Rheumatology
- Pediatrics
Background:
- Juvenile idiopathic arthritis (JIA) is the most prevalent rheumatic condition in children.
- JIA-associated uveitis is the most frequent extra-articular manifestation, posing a significant risk to vision and quality of life.
- Chronic anterior uveitis, often asymptomatic initially, necessitates vigilant screening in at-risk JIA patients.
Purpose of the Study:
- To emphasize the importance of early detection and treatment of JIA-associated uveitis.
- To outline sight-threatening complications including cataracts, glaucoma, band keratopathy, and macular edema.
- To review current and emerging therapeutic strategies for managing JIA-associated uveitis.
Main Methods:
- Review of current literature on JIA-associated uveitis management.
- Highlighting evidence for early systemic immunosuppressive therapies.
- Discussion of a recent randomized controlled trial of adalimumab.
Main Results:
- Adalimumab demonstrates efficacy in JIA-associated uveitis patients refractory to methotrexate.
- Systemic immunosuppressants may reduce the need for topical and systemic glucocorticoids.
- Tocilizumab and abatacept are under investigation for patients inadequately treated with anti-TNF agents.
Conclusions:
- Early intervention in JIA-associated uveitis is vital to prevent irreversible vision loss.
- Biologic therapies, particularly adalimumab, offer a valuable treatment option for refractory cases.
- Ongoing research into agents like tocilizumab and abatacept may expand treatment options for JIA-uveitis.
