Screening for uveitis in juvenile rheumatoid arthritis.

BACKGROUND: Uveitis associated with juvenile rheumatoid arthritis (JRA) is an important cause of visual impairment in children. Because uveitis is often asymptomatic in this age group, frequent ophthalmologic screening examinations are recommended. Recent reports have found a decrease in the prevalence and severity of uveitis in JRA when compared to older data.

METHODS: The charts of 52 consecutive patients with JRA seen over a 30-month period were retrospectively reviewed.

RESULTS: Eye examination identified uveitis in five (12%) patients. All patients with uveitis were female, ANA positive, and had pauciarticular-onset arthritis. Three patients had the onset of uveitis before the age of 2. All patients have maintained good visual acuity and have not developed serious sight-threatening ocular complications over the follow-up period.

CONCLUSIONS: Although the prevalence and severity of JRA-associated uveitis may be decreasing, we strongly recommend continued strict adherence to the current screening guidelines.