Clinical features and immunosuppressive treatment results in cases of uveitis related to juvenile idiopathic arthritis: A retrospective cohort study

PURPOSE: To present the demographic and clinical characteristics and treatment management of patients who were followed with the diagnosis of juvenile idiopathic arthritis-associated uveitis (JIA-U).
METHODS: Data from 66 eyes of 33 patients with JIA-U who were followed in our clinic between 2018 and 2024 were retrospectively reviewed. Demographic findings, best-corrected visual acuity (BCVA) according to the Snellen chart at the first and last visit, ocular complications, applied treatment regimens, side effects of drugs, and need for ocular surgery were retrospectively analyzed. In addition, the age, age at the time of first diagnosis, BCVA values, ocular complications, and surgical needs of patients diagnosed with uveitis before their first visit to our clinic (Group 1) and patients diagnosed with uveitis for the first time by us (Group 2) were compared.
RESULTS: Twenty-seven of the patients were female, six were male, and the mean age was 8.8±3.9 years. All patients had chronic anterior uveitis, and the involvement was bilateral in 30 of them. The most common type was oligoarticular type JIA (84.8%). MTX was the first choice for systemic treatment in all patients. Biological treatment was started in 23 patients. The most common ocular complication was posterior synechiae (49.2%). Posterior synechiae, band keratopathy, and cataract rates were higher in Group 1 (p=0.001, p=0.012, and p=0.026, respectively). The mean initial BCVA value in Group 1 was statistically significantly lower than Group 2 (p<0.05).
CONCLUSION: With a timely and appropriate treatment regimen in JIA-U, the rates of sight-threatening ocular complications can be significantly reduced.

Keywords: Adalimumab, juvenile idiopathic arthritis, methotrexate, ocular complications, uveitis.