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UVESCREEN1: A randomised feasibility study of imaging-based uveitis screening for children with juvenile idiopathic

Sonali Dave1, Jugnoo S Rahi1,2,3,4,5, Harry Petrushkin2,4,6

  • 1Population, Policy and Practice Programme, UCL GOS Institute of Child Health, London, United Kingdom.

Plos One
|February 12, 2025
PubMed

Insights

Optical coherence tomography (AS-OCT) shows promise for detecting childhood uveitis in Juvenile Idiopathic Arthritis (JIA) patients, potentially improving surveillance and reducing the need for frequent, distant eye exams.

Area of Science:

  • Ophthalmology
  • Pediatric Rheumatology
  • Medical Imaging

Background:

  • Juvenile Idiopathic Arthritis (JIA) patients face unpredictable risks of anterior uveitis, a vision-threatening condition.
  • Current surveillance involves frequent, often inconvenient, expert slit lamp examinations (SLE).
  • Optical coherence tomography of the ocular anterior segment (AS-OCT) is a sensitive uveitis detection tool but not standard care.

Purpose of the Study:

  • To assess the feasibility of a randomized controlled trial (RCT) comparing AS-OCT to SLE for uveitis surveillance in JIA.
  • To gather proof-of-concept data for a larger-scale trial on AS-OCT efficacy.

Main Methods:

  • A feasibility RCT involving 80 children (2-12 years) with recent JIA diagnoses.
  • Participants randomized to AS-OCT or SLE surveillance.
  • Outcomes include feasibility, clinical metrics, quality of life (PedsQL), and resource use.

Main Results:

  • Feasibility metrics (recruitment, attrition) will be assessed.
  • Clinical outcomes (uveitis diagnosis) at 12 months will be compared.
  • AS-OCT findings will be compared to SLE ('gold standard') at 6 and 12 months.

Conclusions:

  • This study will inform a larger RCT on AS-OCT's role in JIA uveitis surveillance.
  • AS-OCT may offer a more convenient and effective alternative to current screening methods.
  • Improved surveillance could lead to earlier detection and treatment of childhood uveitis.

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