Frequency and Identification of Risk Factors of Uveitis in Juvenile Idiopathic Arthritis

Background Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood. The JIA–associated uveitis represents the most common extra-articular manifestation. Objectives The main aim of this study was to evaluate frequency and risk factors of uveitis in a pediatric population affected by JIA. Methods One hundred eight Italian children with JIA were followed during a follow-up period of 13 years. Association between uveitis, antinuclear antibodies (ANAs), and subtype of arthritis has been estimated, and Kaplan-Meier curves were generated to assess the probability of ocular complications during the follow-up period. Results Twenty-one patients developed uveitis, after 96.5 ± 50.4 months from the enrollment. According to JIA subtypes, the oligoarthritis subtype was characterized by the highest prevalence (39%) of uveitis. The greatest risk of uveitis has been detected in oligoarthritis patients associated to ANA positivity (risk ratio, 8.6; 95% confidence interval, 2.27–32.9; χ2 = 20.4), whereas the worst evolution was revealed in patients with oligoarthritis and high levels of ANAs, with a progression time of 36 months (log-rank χ2 = 16.39; p < 0.0001; risk ratio, 18; 95% confidence interval, 7.3–44.2). Conclusions Patients with early-onset ANA-positive oligoarticular JIA have the highest risk of developing uveitis. A routine ophthalmological follow-up is required at regular intervals, even though the joint disease is clinically quiescent.