Rodríguez-García Alejandro
Servicio de Inmunología Ocular y Uveítis, Instituto de Otalmología y Ciencias Visuales, Escuela de Medicina y Ciencias de la Salud, TEC Salud, Tecnológico de Monterrey, Monterrey, Nuevo León, México.
Reumatol Clin. 2015 May-Jun;11(3):133-8. doi: 10.1016/j.reuma.2014.08.003. Epub 2014 Dec 2.
Uveitis occurs within the first year of arthritis onset in 73% of patients with juvenile idiopathic arthritis (JIA) considered at risk. The intraocular inflammation is characterized by an insidious onset and a silent and chronic clinical course capable of producing significant visual loss due to complications such as: cataract formation, secondary glaucoma, maculopathy and optic neuropathy. The absence of initial signs and symptoms, along with a deficient ophthalmic monitoring produce a delay in diagnosis with serious consequences. It has been estimated that 47% of JIA patients at risk for developing uveitis are legally blind (20/200 or worse) at least in one eye at the time of their first visit to the ophthalmologist. To reduce ocular complications and improve their visual outcome, it is necessary that rheumatologists refer all patients recently diagnosed (within the first month) with JIA for an ophthalmic evaluation, and maintain periodical follow-up visits based on classification and risk category of the disease.
在被认为有风险的青少年特发性关节炎（JIA）患者中，73%会在关节炎发病后的第一年内出现葡萄膜炎。眼内炎症的特点是发病隐匿，临床过程无声且呈慢性，可能因白内障形成、继发性青光眼、黄斑病变和视神经病变等并发症而导致严重视力丧失。缺乏初始体征和症状，以及眼科监测不足，会导致诊断延迟并产生严重后果。据估计，47%有患葡萄膜炎风险的JIA患者在首次就诊眼科医生时，至少一只眼睛已法定失明（视力20/200或更差）。为减少眼部并发症并改善视力预后，风湿病学家有必要将所有近期（发病后第一个月内）诊断为JIA的患者转介至眼科进行评估，并根据疾病的分类和风险类别进行定期随访。
