Vela J I, Galán A, Fernández E, Romera M, Torres J J
Hospital Universitario Vall D'Hebrón, Barcelona, España.
Arch Soc Esp Oftalmol. 2003 Oct;78(10):561-5.
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).
前葡萄膜炎是幼年特发性关节炎（JIA）最重要的关节外表现之一。本研究旨在描述葡萄膜炎的发生率、并发症及眼科手术情况，证实葡萄膜炎发生的危险因素并分析其演变特征。
回顾性分析1985年至2000年在我院诊断为JIA的132例儿童。对出现前葡萄膜炎（房水闪辉阳性或近期角膜后沉着物）的患者进行研究。
132例儿童中有26例（19%）检测到葡萄膜炎。所有患者均为少关节型JIA。患者接受皮质类固醇治疗的平均时间为19.2个月，平均发生4.5次葡萄膜炎发作。在关节炎发作前或发作1年内诊断为葡萄膜炎的患者比之后诊断为葡萄膜炎的患者需要更长时间的治疗（295个月对206个月）且发作次数更多（73次对44次）。27.9%的患眼出现并发症（白内障、带状角膜病变、青光眼、黄斑水肿）。10只眼需要手术治疗。
我们研究中葡萄膜炎的发生率与近期报道的发生率相似。女性、少关节型起病、血清抗核抗体（ANA）及葡萄膜炎早期发作似乎会增加慢性葡萄膜炎的发生。建议对高危患者定期进行裂隙灯眼科筛查（《西班牙眼科协会杂志》2003年；78：561 - 566）。
