The frequency of uveitis in patients with juvenile inflammatory rheumatic diseases.

OBJECTIVES

This meta-analysis investigated the frequency and type of ocular involvement in juvenile inflammatory arthritis (JIA) and other juvenile rheumatic diseases.

METHODS

Medline, Web of Science and Cochrane databases were searched from inception to September 2018 to identify publications related to juvenile arthritis and rheumatic diseases, which reported frequency of Uveitis in juvenile rheumatic conditions and contained at least 20 patients. The prevalence and type of eye complications were extracted, and random effects models estimated their frequency. Heterogeneity was evaluated using I2.

RESULTS

In total, 7132 unique citations resulted in 59 articles included. Pooled frequency of uveitis was: 24% in oligoarticular JIA, 12% in polyarticular JIA, 1% in systemic JIA, 50% in pediatric Bechet's, 9% in juvenile psoriatic arthritis, 24% in juvenile spondyloarthropathy and 5% in juvenile systemic lupus erythematosus. The most common uveitis in JIA was anterior uveitis, which occurred in 14%; also described as iridocyclitis in 10% of patients. Publication bias was negligible for all conditions except those with few reported studies (juvenile SLE and systemic JIA). Uveitis in JIA was more common in Europe (14%), North America (11%) and the Middle East (12%) than East Asia (7%) and Oceania (3%).

CONCLUSIONS

Ocular involvement (mostly uveitis) in juvenile inflammatory arthritis and other pediatric rheumatic diseases varied between 3% and 50% depending on the underlying condition; and was highest in pediatric Bechet's. In JIA, the highest frequency of uveitis was in oligoarticular JIA; with anterior uveitis being the most frequent type of uveitis. There was variation geographically for uveitis in JIA.