Bou Rosa, Iglesias Estíbaliz, Antón Jordi
Pediatric Rheumatology Unit. Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu 2, 08950, Esplugues, Barcelona, Spain,
Curr Rheumatol Rep. 2014 Aug;16(8):437. doi: 10.1007/s11926-014-0437-4.
Chronic anterior uveitis affects 10-30 % of patients with juvenile idiopathic arthritis (JIA) and is still a cause of blindness in childhood. In most patients it is asymptomatic, bilateral, and recurrent, so careful screening and early diagnosis are important to obtain the best long-term prognosis. The treatment of chronic uveitis associated with JIA is challenging. Initial treatment is based on topical steroids and mydriatic drops. Methotrexate is the most common first-line immunomodulatory drug used. For refractory patients, biologicals, mainly the anti-tumor-necrosis-factor (TNF) drugs adalimumab and infliximab, have been revealed to be effective and have changed the outcome for these patients. Collaboration between pediatric rheumatologists and ophthalmologists is important for the successful diagnosis and treatment of patients with uveitis associated with JIA.
慢性前葡萄膜炎影响10%至30%的幼年特发性关节炎（JIA）患者，仍是儿童失明的一个原因。在大多数患者中，它无症状、双侧且复发，因此仔细筛查和早期诊断对于获得最佳长期预后很重要。与JIA相关的慢性葡萄膜炎的治疗具有挑战性。初始治疗基于局部类固醇和散瞳滴眼液。甲氨蝶呤是最常用的一线免疫调节药物。对于难治性患者，生物制剂，主要是抗肿瘤坏死因子（TNF）药物阿达木单抗和英夫利昔单抗，已被证明有效，并改变了这些患者的治疗结果。儿科风湿病学家和眼科医生之间的合作对于成功诊断和治疗与JIA相关的葡萄膜炎患者很重要。
