Juvenile Idiopathic Arthritis Associated Anterior Uveitis Among Pediatric Patients in the IRIS Registry from 2013-2017.

PURPOSE: To determine the prevalence, clinical characteristics, and visual outcomes in patients with juvenile idiopathic arthritis-associated uveitis (JIA-U).

METHODS

A retrospective analysis was conducted on the IRIS® Registry for patients < 18 years old diagnosed with JIA-U between 2013-2017. Visual acuity (VA) and intraocular pressure (IOP) were taken at baseline and months six and 12. Cox proportional hazard models were used to determine risk factors for poor visual outcomes. Event probability of outcomes was estimated using the Kaplan-Meier method.

RESULTS

One thousand ninety-nine patients with JIA-U were identified; the prevalence was 42.4 per 100,000 pediatric cases (95% CI: 40.0-45.0). Most participants were white (73%) and female (72%). Seventy-nine percent of participants had a VA of 20/25 or better at the time of cohort entry, as compared to 77% at six months and 78% at 12 months. Nineteen percent (95% CI: 15.9% - 22.8%) of patients with good baseline VA (20/25 or better) experienced a drop to 20/50 or worse in the first 12 months. Patients with poorer baseline VA were more likely to experience this event (HR: 2.72, 95% CI: 1.16-6.38, p = 0.018). Twenty percent of patients (95% CI: 16.5% - 22.7%) received their first immunomodulatory therapy in the first two years after cohort entry, and 60.6% added a second IMT within the subsequent year.

CONCLUSION

Our study reports a higher prevalence of JIA-U within the IRIS Registry than prior studies that drew from academic referral centers. Poorer baseline VA was significantly associated with poorer vision outcomes.