Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Complications and Immunosuppression in Patients with Anterior Uveitis and Juvenile Idiopathic Arthritis

Mingels A.1, Hudde T.2, Heiligenhaus A.1
1Department of Ophthalmology at St. Franziskus Hospital, Muenster; 2Department of Ophthalmology, University of Duisburg-Essen.

Purpose: Juvenile idiopathic arthritis (JIA) is one of the major causes of anterior uveitis in childhood. In this study, the epidemiological data, complications and immunosuppressive therapy were analyzed in patients with JIA-associated uveitis and idiopathic anterior uveitis.
Method: Retrospective study of children with JIA–associated anterior uveitis (n=50) and with idiopathic anterior uveitis without associated diseases (IAU; n=34). Diagnostic features, epidemiological data, uveitis-related complications, medical and surgical therapy and the course of vision were analyzed.
Results: The uveitis in JIA-patients was mostly asymptomatic and was diagnosed within screening-visits (n= 35). In contrast, uveitis-symptoms were apparent in many of the IAU patients (n= 28). Occasionally, the onset of JIA-uveitis was before the age of 4 years. Uveitis-related complications were more common in JIA (n=45) than in IUA (n=15). Immunosuppression was indicated in 34 patients with JIA, but only in 8 patients with IAU. Operations were required more often in the JIA-group (n=36) than in IAU-patients (n= 12). In 18 JIA patients, the initial vision was impaired in one eye, and further 18 had bilateral visual impairment. During the follow-up, the vision improved in 26 patients, but deteriorated in 15. In contrast, only 11 IAU-patients had unilateral impairment of vision at the initial visit; subsequently, the vision improved in 14 patients, and dropped in only 3.
Conclusions: Compared with the patients with idiopathic anterior uveitis, JIA-associated uveitis manifests earlier, has a higher rate of complications, an unfortunate visual course, and more frequently indicates immunosuppression.

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