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Am J Ophthalmol. 2007 Oct;144(4):574-9. Epub 2007 Aug 16.

Risk factors for the development of cataract requiring surgery in uveitis associated with juvenile idiopathic arthritis.

Author information

  • 1FC Donders Institute of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands. K.Sijssens@umcutrecht.nl

Abstract

PURPOSE:

To identify the possible risk factors for the development of cataract requiring surgery in children with juvenile idiopathic arthritis (JIA)-associated uveitis.

DESIGN:

Retrospective cohort study.

METHODS:

Data of 53 children with JIA-associated uveitis, of whom 27 had undergone cataract extraction (CE), were obtained. The main outcome measure, the interval between the onset of uveitis and the first CE (U-CE interval), was examined in relation to clinical and ophthalmologic characteristics and treatment strategies before CE.

RESULTS:

A shorter U-CE interval was found for children with posterior synechia vs those without posterior synechia (hazard ratio [HR], 3.57; 95% confidence interval [CI], 1.33 to 10.00). No significant difference was found for children in whom the uveitis was the first manifestation of JIA vs those in whom arthritis was the first manifestation of JIA (HR, 1.59; 95% CI, 0.63 to 4.00) and children treated with periocular corticosteroid injections vs those not treated with periocular corticosteroid injections (HR, 3.23; 95% CI, 0.95 to 11.11). Children treated with methotrexate (MTX) had a longer U-CE interval than children not treated with MTX (HR, 0.29; 95% CI, 0.10 to 0.87).

CONCLUSIONS:

The risk factor for development of early cataract requiring surgery in children with JIA-associated uveitis is the presence of posterior synechia at the time of diagnosis of uveitis. However, early treatment with MTX is associated with a mean delay in the development of cataract requiring surgery of 3.5 years.

PMID:
17706583
DOI:
10.1016/j.ajo.2007.06.030
[PubMed - indexed for MEDLINE]
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