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16-11-2017 | Juvenile idiopathic arthritis | Review | Article

Update on the Treatment of Uveitis in Patients with Juvenile Idiopathic Arthritis: A Review

Journal: Advances in Therapy

Authors: Ioannis Asproudis, Andreas Katsanos, Nikolaos Kozeis, Alexandra Tantou, Anastasios G. Konstas

Publisher: Springer Healthcare

Abstract

Chronic uveitis is a common extra-articular manifestation of juvenile idiopathic arthritis. The classic clinical picture is one of chronic anterior uveitis, which usually remains asymptomatic until ocular complications arise. The risk of uveitis is increased in girls with an early onset of oligoarthritis and positive antinuclear antibodies. Even though the inflammation in patients with juvenile idiopathic arthritis is initially limited in the anterior part of the eye, chronic active inflammation may eventually cause significant damage to the posterior pole. Complications may include band keratopathy, cataract, secondary glaucoma, posterior synechiae, cystoid macular edema, and hypotony. The cooperation of ophthalmologists with rheumatologists may help define the best treatment plan. The ophthalmic therapeutic regimen includes topical corticosteroids and mydriatics, while in severe cases immunosuppressive and biological agents are introduced. Surgical management of complications might be needed.

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