Kolomeyer Anton M, Crane Elliot S, Tu Yufei, Liu Dan, Chu David S
Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Pennsylvania.
Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey.
Can J Ophthalmol. 2017 Oct;52(5):458-462. doi: 10.1016/j.jcjo.2017.01.011. Epub 2017 Mar 18.
To describe clinical characteristics and outcomes of adults with uveitis associated with juvenile idiopathic arthritis (JIA).
Retrospective chart review from 2001 to 2014 of adult patients with JIA and follow-up ≥2 months. Outcome measures included visual acuity, intraocular pressure (IOP), inflammation grade, ocular findings/complications, immunosuppressive therapies, and surgeries.
Nineteen patients were included (95% female, 84% bilateral uveitis, 47% anterior uveitis). Mean (SD) ages at presentation and JIA diagnosis were 25.6 (7.8) years and 8.9 (5.6) years, respectively. Visual acuity and IOP did not significantly change throughout the study. Mean (SD) presenting inflammation grade was significantly decreased at 6 and 12 months. Fifteen (79%) patients were on topical medications, and 17 (89%) were on systemic immunosuppression. Two (12%) patients developed side effects requiring medication cessation.
Uveitis associated with JIA may extend into adulthood despite the use of topical medications and/or systemic immunosuppression and result in significant ocular morbidity, including the need for surgical intervention.
描述与幼年特发性关节炎(JIA)相关的葡萄膜炎成年患者的临床特征及预后。
对2001年至2014年JIA成年患者进行回顾性病历审查,随访时间≥2个月。观察指标包括视力、眼压(IOP)、炎症分级、眼部表现/并发症、免疫抑制治疗及手术情况。
共纳入19例患者(95%为女性,84%为双侧葡萄膜炎,47%为前葡萄膜炎)。就诊时及JIA诊断时的平均(标准差)年龄分别为25.6(7.8)岁和8.9(5.6)岁。在整个研究过程中,视力和眼压无显著变化。6个月和12个月时,初始炎症分级的平均值(标准差)显著降低。15例(79%)患者使用局部药物治疗,17例(89%)患者接受全身免疫抑制治疗。2例(12%)患者出现需要停药的副作用。
尽管使用了局部药物和/或全身免疫抑制治疗,但与JIA相关的葡萄膜炎可能会持续到成年期,并导致严重的眼部疾病,包括需要手术干预。