Juvenile Idiopathic Arthritis Associated Anterior Uveitis Among Pediatric Patients in the IRIS Registry from...

Area of Science:

• Ophthalmology
• Rheumatology
• Pediatrics

Background:

• Juvenile idiopathic arthritis (JIA) is a common cause of chronic uveitis in children.
• Uveitis associated with JIA can lead to significant visual impairment and long-term complications.
• Understanding the prevalence and outcomes of JIA-associated uveitis (JIA-U) is critical for effective management.

Purpose of the Study:

• To determine the prevalence of JIA-U in a large pediatric registry.
• To characterize the clinical features and visual outcomes of patients with JIA-U.
• To identify risk factors associated with poor visual outcomes in JIA-U.

Main Methods:

• Retrospective analysis of the IRIS® Registry (2013-2017) for patients under 18 with JIA-U.
• Evaluation of visual acuity (VA) and intraocular pressure (IOP) at baseline, 6, and 12 months.
• Use of Cox proportional hazard models and Kaplan-Meier methods to assess risk factors and outcome probabilities.

Main Results:

• Identified 1,099 patients with JIA-U, a prevalence of 42.4 per 100,000 pediatric cases.
• Seventy-nine percent had good baseline VA (≥20/25), with 19% experiencing a decline to ≤20/50 within 12 months.
• Poorer baseline VA was a significant risk factor for worse visual outcomes (HR: 2.72, p=0.018).
• Twenty percent received initial immunomodulatory therapy (IMT) within two years, with 60.6% adding a second IMT within the following year.

Conclusions:

• The IRIS Registry indicates a higher prevalence of JIA-U than previously reported from academic centers.
• Baseline visual acuity is a critical predictor of long-term visual outcomes in pediatric patients with JIA-U.
• Aggressive management with immunomodulatory therapies is often required for JIA-U.