Saurenmann R K, Levin A V, Feldman B M, Rose J B, Laxer R M, Schneider R, Silverman E D
Department of Pediatrics, University Children's Hospital, Zurich, Switzerland.
Arthritis Rheum. 2007 Feb;56(2):647-57. doi: 10.1002/art.22381.
To assess the prevalence, risk factors, and long-term outcome of uveitis in patients with juvenile idiopathic arthritis (JIA).
An inception cohort of all 1,081 patients diagnosed as having JIA at a single tertiary care center was established. A questionnaire and followup telephone calls were used to confirm the diagnosis of uveitis. Ophthalmologists' records of patients with uveitis were collected. Kaplan-Meier and Cox regression analyses were used to assess risk factors for developing uveitis and for complications of uveitis.
After a mean followup time of 6.9 years, 142 of 1,081 patients (13.1%) had developed uveitis. Risk factors were young age at diagnosis, female sex, antinuclear antibody positivity, and the subtype of JIA. The relative contribution of these risk factors was different for the different subtypes of JIA. Until the end of the study, uveitis complications had developed in 53 of 142 patients with uveitis (37.3%; 4.9% of the total cohort). Only 16 of 175 involved eyes (9.1%) in 14 of 108 patients (13%; 1.3% of the total cohort) for whom ophthalmology reports were available had best corrected visual acuity less than 20/40 (mean followup time for uveitis of 6.3 years). Abnormal vision was associated with synechiae or cataract.
Risk factors for developing uveitis were different among subtypes of JIA. The long-term outcome of JIA-associated uveitis in our cohort was excellent despite the high rate of complications.
评估青少年特发性关节炎(JIA)患者葡萄膜炎的患病率、危险因素及长期预后。
在一家三级医疗中心建立了一个起始队列,纳入所有1081例被诊断为JIA的患者。通过问卷调查和随访电话确认葡萄膜炎的诊断。收集葡萄膜炎患者的眼科医生记录。采用Kaplan-Meier法和Cox回归分析评估发生葡萄膜炎及葡萄膜炎并发症的危险因素。
平均随访6.9年后,1081例患者中有142例(13.1%)发生了葡萄膜炎。危险因素包括诊断时年龄小、女性、抗核抗体阳性及JIA的亚型。这些危险因素在不同亚型JIA中的相对作用不同。至研究结束时,142例葡萄膜炎患者中有53例(37.3%;占整个队列的4.9%)出现了葡萄膜炎并发症。在有眼科报告的108例患者中的14例(占整个队列的1.3%)中,175只受累眼中只有16只(9.1%)最佳矫正视力低于20/40(葡萄膜炎平均随访时间为6.3年)。视力异常与粘连或白内障有关。
JIA各亚型发生葡萄膜炎的危险因素不同。尽管并发症发生率高,但我们队列中JIA相关葡萄膜炎的长期预后良好。