Clinical Characteristics and Ocular Complications of Uveitis in Juvenile Idiopathic Arthritis: A Cross-sectional Study from a Tertiary Pediatric Center

Abstract

Background: Uveitis is a major complication of juvenile idiopathic arthritis (JIA), particularly in the oligoarticular subtype, and may have an insidious onset. Timely diagnosis and treatment can reduce the risk of permanent visual damage. Objectives: This study investigated the clinical profile and treatment outcomes of uveitis in children with JIA, emphasizing the importance of early diagnosis and management. Methods: This cross-sectional study reviewed the records of 28 pediatric patients with JIA-associated uveitis among 342 patients with JIA who were referred to Akbar Children's Hospital between 2016 and 2019. Clinical, laboratory, and ophthalmologic data were collected retrospectively and analyzed using SPSS version 26. Results: Uveitis was present in 8.2% of patients with JIA, with the highest proportion among patients with oligoarticular-onset disease (82.1%). Most cases were chronic anterior uveitis with bilateral involvement. Ocular complications were observed in more than half of the patients, most commonly posterior synechiae (25%) and cataract (17.9%). Antinuclear antibody positivity was noted in 26.1% of oligoarticular cases and 66.7% of psoriatic arthritis cases. Uveitis recurred in 39.3% of patients, and 10.7% were classified as refractory to initial treatment. Topical and systemic corticosteroids were frequently used, and methotrexate was prescribed in 92.8% of patients. Biologic therapy was administered to 21.4% of patients, primarily in patients with refractory disease or intolerance to methotrexate. Conclusions: JIA-associated uveitis remains a major contributor to ocular morbidity despite standard treatment. Patients with JIA experience frequent recurrences and complications, underscoring the need for early screening and, when necessary, aggressive immunosuppression.