Peng Xin, Liu Qiao, Lin Li, Dong Liqun
Division of Pediatric Pulmonology and Immunology, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, Sichuan, 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, Sichuan, 610041, China.
Pediatr Rheumatol Online J. 2025 Jul 14;23(1):71. doi: 10.1186/s12969-025-01122-2.
Uveitis is a serious complication of juvenile idiopathic arthritis (JIA). Despite its seriousness, a comprehensive understanding of its incidence and early risk factors remains elusive. This knowledge gap poses challenges for formulating tailored clinical early identification and prevention strategies. Therefore, our study aims to review the incidence and risk factors of uveitis in JIA patients, and provide evidence-based insights for developing specific clinical risk identification and prevention strategies.
We systematically searched databases including PubMed, Cochrane, Embase, and Web of Science until December 31, 2023. The quality of included studies was assessed through the Newcastle-Ottawa Scale (NOS). Incidence data were synthesized from cohort studies, and meta-analysis was conducted through R language.
Our review encompassed 28 original studies involving 22,834 JIA patients, among whom 3,381 developed uveitis during the follow-up period. Meta-analysis revealed an overall prevalence of uveitis at 12.7% (95% CI: 10.5 - 15.1%), with rates of 14.3% (95% CI: 11.9 - 15.1%) in European populations, 6.5% (95% CI: 4.0 - 9.5%) in Asian populations, and 13.4% (95% CI: 9.5 - 17.8%) in North America. Identified risk factors for the development of uveitis included early age at JIA onset, ANA-positive, and increased ESR.
The notable prevalence of uveitis in JIA demands clinical vigilance. Our study findings highlight that age, ANA status, and ESR correlate with risk of complicated uveitis. Future research endeavors could focus on constructing a concise risk assessment tool incorporating more potent independent factors. Such a tool would enhance screening efficacy within this demographic, facilitating tailored preventive strategies.
葡萄膜炎是青少年特发性关节炎（JIA）的一种严重并发症。尽管其严重性，但对其发病率和早期危险因素的全面了解仍然难以捉摸。这种知识差距给制定针对性的临床早期识别和预防策略带来了挑战。因此，我们的研究旨在回顾JIA患者葡萄膜炎的发病率和危险因素，并为制定具体的临床风险识别和预防策略提供循证见解。
我们系统检索了包括PubMed、Cochrane、Embase和Web of Science在内的数据库，检索截至2023年12月31日的文献。通过纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。从队列研究中综合发病率数据，并通过R语言进行荟萃分析。
我们的综述涵盖了28项涉及22,834例JIA患者的原始研究，其中3,381例在随访期间发生了葡萄膜炎。荟萃分析显示葡萄膜炎的总体患病率为12.7%（95%CI：10.5 - 15.1%），欧洲人群中的患病率为14.3%（95%CI：11.9 - 15.1%），亚洲人群中的患病率为6.5%（95%CI：4.0 - 9.5%），北美人群中的患病率为13.4%（95%CI：9.5 - 17.8%）。已确定的葡萄膜炎发生危险因素包括JIA发病时年龄较小、抗核抗体（ANA）阳性和红细胞沉降率（ESR）升高。
JIA中葡萄膜炎的显著患病率需要临床警惕。我们的研究结果强调年龄、ANA状态和ESR与复杂性葡萄膜炎的风险相关。未来的研究可以致力于构建一个包含更有效独立因素的简明风险评估工具。这样的工具将提高该人群的筛查效率，促进针对性的预防策略。
