Non-JIA childhood uveitis rare, says study

Childhood uveitis not associated with juvenile idiopathic arthritis (JIA) seems to occur very rarely, a recent study has found.

Through the British and Scottish Ophthalmological Surveillance Units, the researchers identified 80 children (aged 0–16 years; 52 percent boys) who had been newly diagnosed with uni- or bilateral uveitis but had no known JIA or ocular trauma. The resulting annual incidence of non-JIA uveitis was 0.66 per 100,000.

Presenting at a median age of 10 years, majority (72.9 percent) had bilateral uveitis, with the most common symptoms being red eye (54 percent), painful eye (42 percent), reduced vision (39 percent), and photophobia (12 percent). Four children had asymptomatic uveitis caught only on routine eye examinations.

The median best corrected visual acuity in the worse eye was 0.3 logMAR, which improved to 0.1 after 1 year. None of the participants were eligible for sight-impairment certification.

Topical corticosteroids were the most commonly used treatment (87 percent), while two participants received nonsteroidal topical medications. Meanwhile, systemic treatment was initiated in 32 percent of patients, and 16 percent were subjected to invasive procedures. Notably, six patients (10 percent) received no treatment.

At 1 year, 73 percent remained on topical treatment and 65 percent on systemic treatment. Despite ongoing management, 46 percent still showed intraocular inflammation. Regardless, outcomes were generally favourable, with only four children showing worse vision at 1 year vs baseline.

“Ultimately the aim is to prevent or minimize ocular inflammation, to reduce the risks of permanent visual impairment. All children with noninfectious uveitis should have a full paediatric rheumatology review to ensure that there is no concurrent joint involvement before making a diagnosis of non-JIA uveitis,” the researchers said.