Li Li, Zhang Jun-Mei, Deng Jiang-Hong, Kuang Wei-Ying, Tan Xiao-Hua, Li Chao, Li Shi-Peng, Li Cai-Feng
Department of Rheumatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, People's Republic of China.
Clin Ophthalmol. 2025 Aug 18;19:2813-2820. doi: 10.2147/OPTH.S529421. eCollection 2025.
To characterize the clinical features, risk factors, and outcomes of juvenile idiopathic arthritis-associated uveitis (JIA-U), aiming to improve early detection and management strategies.
This study conducted a retrospective cohort analysis of JIA patients diagnosed and treated at the Department of Rheumatology at Beijing Children's Hospital (2016-2023), with subgroup evaluation of JIA-U cases.
Among 1494 JIA patients, 72 (4.82%) developed uveitis. The oligoarticular subtype (OJIA, 47.2%) and enthesitis-related arthritis (ERA, 27.8%) predominated. Uveitis onset occurred at a median of 10 months post-arthritis diagnosis (range: 0-86 months), with 93% manifesting within 4 years. Chronic anterior uveitis was the most frequent phenotype. ANA positivity and HLA-B27 were significantly associated uveitis. First-line acute management involved topical corticosteroids, with methotrexate escalation for severe cases and TNF-α inhibitors (adalimumab preferred) for refractory disease. Ocular complications arose in 25.9% during follow-up.
Uveitis, often bilateral and insidious, is a common extra-articular manifestation of JIA. Absent arthritis signs may delay diagnosis, highlighting the need for regular screening and close rheumatology-ophthalmology collaboration to optimize outcomes.
描述青少年特发性关节炎相关性葡萄膜炎（JIA-U）的临床特征、危险因素及预后，旨在改善早期检测和管理策略。
本研究对在北京儿童医院风湿免疫科诊断和治疗的JIA患者（2016 - 2023年）进行回顾性队列分析，并对JIA-U病例进行亚组评估。
在1494例JIA患者中，72例（4.82%）发生葡萄膜炎。少关节型（OJIA，47.2%）和附着点炎相关关节炎（ERA，27.8%）最为常见。葡萄膜炎发病时间中位数为关节炎诊断后10个月（范围：0 - 86个月），93%在4年内出现。慢性前葡萄膜炎是最常见的表型。ANA阳性和HLA - B27与葡萄膜炎显著相关。一线急性治疗包括局部使用糖皮质激素，重症病例增加甲氨蝶呤，难治性疾病使用TNF-α抑制剂（首选阿达木单抗）。随访期间25.9%出现眼部并发症。
葡萄膜炎通常为双侧且隐匿性，是JIA常见的关节外表现。无关节炎体征可能会延迟诊断，强调需要定期筛查以及风湿免疫科与眼科密切合作以优化预后。
