Juvenile idiopathic arthritis-associated uveitis outcomes at an Australian tertiary paediatric hospital

We performed a retrospective cohort study exploring juvenile idiopathic arthritis (JIA)-associated uveitis (JIA-U) screening practices and outcomes at a tertiary paediatric centre. The aim was to present data to inform a revised uveitis screening protocol.

All patients diagnosed with JIA at the Royal Children's Hospital, Melbourne, Australia, between September 2021 and December 2023 were identified through the hospital electronic medical record. Demographic and clinical details were extracted and analysed.

A total of 136 patients were identified and 107 were included in the analysis. Mean time from JIA diagnosis to chart review was 3.5 years. The mean age was 8.6 years and 71 (66.3%) were female. The most common JIA subtypes were oligoarticular (n = 41, 38.3%), rheumatoid factor negative polyarticular (n = 33, 30.8%) and enthesitis related (n = 15, 14.0%). Eighty-eight of 107 (82.2%) had at least one documented eye assessment overall including all 32 patients considered high-risk according to preexisting guidelines. Fifteen (14.0%) patients were diagnosed with uveitis; two prior to JIA diagnosis, seven within a year following JIA diagnosis and six more than a year following JIA diagnosis. At the time of uveitis diagnosis, three patients (20%) had ocular complications (two with synechiae, one with synechiae and vitreous haze) and none had significant visual loss.

Adherence to preexisting JIA-U screening guidelines was suboptimal though better in high-risk patients. Few patients had significant ocular complications at time of uveitis diagnosis and none had significant visual impairment. Improved adherence to screening guidelines is an important step towards optimising uveitis outcomes.