Solebo Ameenat Lola, Foeldvari Ivan
Uveitis Department, Great Ormond Street Hospital NHS Foundation Trust, London, UK.
UCL GOS Institute of Child Health, University College London, London, WC1N 1EH, UK.
Pediatr Rheumatol Online J. 2025 Jan 20;23(1):4. doi: 10.1186/s12969-024-01037-4.
Childhood blindness significantly impacts development, education, employment, and mental health, creating burden for families and society. Between 8% and 30% of children with Juvenile Idiopathic Arthritis (JIA) develop a potentially blinding chronic inflammatory eye disease, uveitis (JIAU). Alongside the use of disease-modifying agents and anti-TNF immunomodulators, JIAU surveillance has helped to reduce the risk of JIAU related blindness.Inconsistent guidance on JIAU surveillance has previously been a hindrance to care delivery and access for professional and families. The Multinational Interdisciplinary Working Group for Uveitis in Childhood (MIWGUC) has brought some much-needed standardisation to JIA surveillance, developing a consensus-based screening proposal which simplifies the protocol, supporting implementation amongst non-specialists, and ensuring that children at risk receive the timely eye examination necessary to avoid life-changing visual disability. In this commentary on the MIWGUC surveillance proposal, we also address the implementation of such surveillance. A global shortage of ophthalmologists threatens the sustainability of these surveillance programs. Innovative approaches could be imaging-based detection. The accessibility of Optical Coherence Tomography (OCT) imaging may make OCT a feasible future option for community-based surveillance, reducing the burden on ophthalmologists, and on patients and their families.
儿童失明对其发育、教育、就业和心理健康有重大影响，给家庭和社会带来负担。在幼年特发性关节炎（JIA）患儿中，8%至30%会患上一种可能致盲的慢性炎症性眼病——葡萄膜炎（JIAU）。除了使用改善病情的药物和抗TNF免疫调节剂外，JIAU监测有助于降低与JIAU相关的失明风险。此前，关于JIAU监测的指导意见不一致，这一直是专业人员和家庭提供护理及获得护理的障碍。儿童葡萄膜炎跨国跨学科工作组（MIWGUC）为JIA监测带来了一些急需的标准化措施，制定了一项基于共识的筛查建议，该建议简化了方案，支持非专科医生实施，并确保有风险的儿童能及时接受必要的眼部检查，以避免改变生活的视力残疾。在这篇关于MIWGUC监测建议的评论中，我们还讨论了这种监测的实施情况。全球眼科医生短缺威胁着这些监测项目的可持续性。创新方法可能是基于成像的检测。光学相干断层扫描（OCT）成像的可及性可能使OCT成为未来基于社区监测的可行选择，减轻眼科医生以及患者及其家庭的负担。
