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Risk Factors and Longterm Outcome of Juvenile Idiopathic Arthritis-Associated Uveitis in Switzerland

ISABEL BETTINA BOLT, ELVIRA CANNIZZARO, REINHARD SEGER, and ROTRAUD KATHARINA SAURENMANN

ABSTRACT.

Objective.
To determine rate, risk factors, and longterm outcome of uveitis in children with juvenile idiopathic arthritis (JIA) in Switzerland and compare the results with a study of a different center in Switzerland from 1992.

Methods. Retrospective analysis of the charts and ophthalmologists' reports of all patients with JIA in a tertiary care outpatient clinic between January 1, 1997, and December 31, 2005, for diagnosis, course, and outcome of uveitis.

Results. Uveitis occurred in 35/265 patients (13.2%) of our JIA cohort, which is similar to the 16% reported in the 1992 cohort. A positive test for antinuclear antibodies was the strongest risk factor. The JIA subgroup with the highest rate of uveitis was "other arthritis," followed by oligoarticular JIA. Extended and persistent course of oligoarticular JIA had a similar uveitis incidence, but all patients with extended-course disease developed uveitis before more than 4 joints were affected. After a mean followup of 5.62 years (range 0.5-15.17), 12/35 (34%) patients with uveitis had developed uveitis complications. Best corrected visual acuity was normal in 91% of patients. Only 5.6% of the affected eyes were legally blind as compared to 17.6% in the 1992 cohort.

Conclusion. The rate of uveitis was 13.2% in our cohort of Swiss children and has not changed since 1992. Despite the high rate of uveitis complications, the longterm visual outcome was excellent. (J Rheumatol First Release Feb 15 2008)

Key Indexing Terms:

UVEITIS
JUVENILE IDIOPATHIC ARTHRITIS
EPIDEMIOLOGY
RISK FACTORS
OUTCOME


From Zürich University Children's Hospital, Zürich, Switzerland.

Supported by Rheumaliga Schweiz.

I.B. Bolt, MD, Consultant; E. Cannizzaro, MD, Fellow; R.K. Saurenmann, MD, Head, Pediatric Rheumatology; R. Seger, MD, MSc, Professor, Head, Pediatric Immunology.

Address reprint requests to Dr. R. Saurenmann, Zürich University Children's Hospital, Postal Box 8032, Zürich, Switzerland. E-mail: traudel.saurenmann@kispi.uzh.ch

Accepted for publication November 22, 2007.



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