O R I G I N A L R E S E A R C H Uveitis and juvenile idiopathic arthritis: A cohort study David BenEzra1 Evelyne Cohen1 Francine Behar-Cohen2 1Hadassah University Hospital, Jerusalem, Israel; 2Hotel Dieu Hospital and U598 INSERM Paris, France Correspondence: David BenEzra Pediatric Ophthalmology Unit, Hadassah Hospital, POB 12000, Jerusalem 91120, Israel Tel +972 2 6776 397 Fax +972 2 6778 297 Email benezraophtha@gmail.com Objective: Assess the incidence of intraocular inﬂammation (uveitis) and ocular complications in children with various types of JIA in a single cohort of patients. Patients: Included are 172 children (35 boys and 137 girls) diagnosed with JIA. All underwent thorough initial ophthalmologic examination and were followed for a minimum of 3 years. Results: Of 172 children with JIA, 152 (88.4%) presented with arthritis. Uveitis was detected in 14 of the152 children (9.2%) during the ﬁrst ophthalmic examination. In 17 additional patients of this group (11.2%), uveitis developed during the follow up period of up to 15 years. Twenty children out of the total of 172 (11.6%) presented initially with uveitis. In children develop- ing uveitis before or along with arthritic manifestations, the ocular disease was chronic with a high rate of secondary complications (band keratopathy, glaucoma, posterior synechiae and cataract). In all affected eyes the initial ocular inﬂammation was typically conﬁned to the anterior segment. On longer follow up however, most children developed binocular disease and posterior segment involvement. Dense cataract and amblyopia were the major cause of severe visual disabilities. Conclusion: Pauciarticular JIA is associated with intraocular inﬂammation (uveitis) early during the arthritic disease course. The ocular disease course is unpredictable. Therefore education of parents regarding its signs and symptoms is of utmost importance. To preserve functional vision, secondary ocular complications and amblyopia should be avoided. Keywords: arthritis, eye, JIA, uveitis, intraocular inﬂammation, visual acuity, cataract, glaucoma Juvenile rheumatoid arthritis (JRA) or juvenile idiopathic arthritis (JIA) is a frequent systemic disease of childhood which is associated with intraocular inﬂammation (uveitis). JIA has been reported as the accompanying systemic manifestation in 81% of children with uveitis (Kanski and Shun-Shin 1984) and in 95% of those with anterior uveitis (O’Brien and Albert 1989). More recently, JIA was detected as the associated systemic manifestation in 41.5% of 130 children with uveitis (Tugal-Tutkun et al 1996). A prospective study carried out for a period of 10 years in our specialized uveitis clinic demonstrated that only 14.9% of 276 children and adolescents with uveitis had JIA (BenEzra et al 2005). These different incidences of the most prevalent causes for uveitis in children and those observed in adults have been attributed to “changing patterns of uveitis” (Henderly et al 1987; Tugal-Tutkun et al 1996). Despite all management care and modern treatment modalities, JIA remains an important cause of vision loss and blindness in most developed countries worldwide (Kanski et al 1990; Akduman et al 1997; Dollfus 1998; BenEzra and Cohen 2000; Kotaniemi et al 2001; Grassi et al 2007; Henligenhaus et al 2007). While the reported relative prevalence of JIA-associated ocular disease varies markedly among children with uveitis, the most severe ocular complications are observed in young girls with the pauciarticular type and bilateral eye involvement. This group of children therefore deserves special clinical and surgical Clinical Ophthalmology 2007:1(4) 513–518 © 2007 Dove Medical Press Limited. All rights reserved 513