Nuclear cataract as an early predictive factor for recalcitrant juvenile idiopathic arthritis-associated uveitis.

Abstract

PURPOSE:

To analyze factors predictive of having treatment-resistant uveitis in patients with juvenile idiopathic arthritis (JIA)-associated uveitis.

METHODS:

The medical records of patients diagnosed with JIA-associated uveitis treated at a single tertiary referral center from October 2005 to March 2013 were reviewed retrospectively. The main outcome measures were demographic characteristics, ocular comorbidity, clinical course, treatments, and baseline risk factors associated with poor response to first-line therapies.

RESULTS:

A total of 96 patients (175 eyes) were included. Of these, 58 patients (108 eyes) required biologic disease-modifying antirheumatic drugs or alkylating agents for their uveitis during follow-up (recalcitrant group), and 38 patients (67 eyes) did not (nonrecalcitrant group). Eyes of the recalcitrant group tended to have a higher incidence of cataract at baseline (49%; P < 0.0001). In the nonrecalcitrant group, the most frequent complications were cataract (20.9%) and secondary glaucoma (20.9%). The mean number of flares in the recalcitrant group was significantly reduced from 3.7/eye/year prior to cataract surgery to 1.6/eye/year after (P < 0.0001). Nuclear cataract was found to be an independent predictor for a severe course of JIA-associated uveitis. Any other type of cataract, posterior synechiae, male sex, or active uveitis at baseline were not found to be independently associated with recalcitrant uveitis.

CONCLUSIONS:

Nuclear cataract at baseline evaluation is a risk factor for poor response to first-line therapies in JIA-associated uveitis patients.

• Authors: Ana M Suelves, Neerav Lamba, Halea K Meese, C Stephen Foster, Jesus Maria González-Martín, Manuel Díaz-Llopis, William G Christen
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 20 Issue 3 Pg. 232-238.e1 (06 2016) ISSN: 1528-3933 [Electronic] United States
• PMID: 27164426 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Chemical References

• Antirheumatic Agents

Topics

• Antirheumatic Agents (therapeutic use)
• Arthritis, Juvenile (diagnosis, drug therapy)
• Cataract (congenital, diagnosis)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Retrospective Studies
• Risk Factors
• Uveitis (diagnosis, drug therapy)
• Visual Acuity (physiology)