Siiskonen, M., Hirn, I., Pesälä, R. et al. Encouraging visual outcomes in children with idiopathic and JIA associated uveitis: a population-based study. Pediatr Rheumatol 21, 56 (2023). https://doi.org/10.1186/s12969-023-00841-8
Encouraging visual outcomes in children with idiopathic and JIA associated uveitis : a population-based study
|Author:||Siiskonen, Mira1,2,3; Hirn, Iida2,3; Pesälä, Roosa2,3;|
1Department of Ophthalmology, Oulu University Hospital, Oulu, Finland
2Research Unit of Clinical Medicine, Oulu, Finland
3Medical Research Center, University of Oulu, Oulu, Finland
4The Research Unit of Surgery, Anesthesia and Intensive care, Oulu University Hospital and University of Oulu, Oulu, Finland
5Research Service Unit, Oulu University Hospital, Oulu, Finland
6Research Unit of Clinical Medicine and MRC Oulu, Department of Ophthalmology, University of Oulu, Oulu University Hospital, Oulu, P.O.Box 21, 90029 OYS, Finland
|Online Access:||PDF Full Text (PDF, 0.7 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe20230928137694
|Publish Date:|| 2023-09-28
Background: Pediatric uveitis is typically asymptomatic and may become chronic affecting ocular structures and vision. We evaluated visual outcomes, clinical features, medication, and uveitis activity in children with either idiopathic uveitis (idio-U) or juvenile idiopathic arthritis associated uveitis (JIA-U).
Methods: A longitudinal, population-based cohort study of children with uveitis in 2008–2017. The data included parameters for age, gender, age at diagnosis, laterality, chronicity, anatomical distribution, etiology, systemic association, uveitis activity, medication, and visual outcomes.
Results: A total of 119 patients aged < 16 years with uveitis were included. Uveitis was idio-U in 23% and associated with JIA in 77% of cases. 37% of the patients in the idio-U group and 65% in the JIA-U were girls (p = 0.014). The mean age at first uveitis was 10.0 (SD 3.4) years in idio-U and 5.5 (SD 3.3) years in JIA-U (p < 0.001). Anterior location of uveitis was noted in 74% in idio-U and 99% in JIA-U (p < 0.001). Mostly, uveitis was chronic (59% in idio-U and 75% in JIA-U) and bilateral (56% in idio-U and 64% in JIA-U). Topical corticosteroids were initially used by 89% and 100%, systemic corticosteroids by 30% and 27% in some extent during the follow-up, disease-modifying antirheumatic drugs (DMARDs) by 33% and 85% (p < 0.001) of the patients in idio-U and JIA-U, respectively. Biologic disease-modifying antirheumatic drugs (bDMARDs) were more common in JIA-U (55% vs. 15% in idio-U, respectively, p < 0.001). Most patients had normal visual acuity (Snellen > 0.8, [6/7.5]) in the affected eye and bilaterally in 85% idio-U and 70% JIA-U. Only 5 patients (4%) had visual impairment in one, but none in both eyes. Uveitis activity by SUN classification was 0 + in 81% and 72%, 0.5 + in 19% and 25%, and 1 + in 0% and 3% in the idio-U and JIA-U, respectively.
Conclusions: Children with uveitis have good visual acuity and a low rate for visual impairment. In addition, modern treatment with DMARDs and bDMARDs seems to save vision.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3125 Otorhinolaryngology, ophthalmology
Finnish Eye Foundation, Mary and Georg C. Ehrnrooth Foundation, Oulu University Hospital VTR grant (K71769). Open Access funding provided by University of Oulu including Oulu University Hospital.
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