Male gender and poor visual outcome in uveitis associated with juvenile idiopathic arthritis

Viera Kalinina Ayuso, Hermine Adriana Theodore Ten Cate, Patricia van der Does, Aniki Rothova, Joke Helena de Boer
American Journal of Ophthalmology 2010, 149 (6): 987-93

PURPOSE: To analyze visual outcome in uveitis associated with juvenile idiopathic arthritis (JIA) according to age of onset of uveitis, gender, and initial manifestation of JIA.

DESIGN: Retrospective nonrandomized interventional case series.

METHODS: Visual outcome of 117 affected eyes (65 patients) with JIA-associated uveitis was noted at onset of uveitis and after 1, 3, and 5 years. Visual outcome was analyzed according to gender, age of onset of JIA-associated uveitis (<7 years and >7 years), and initial manifestation of JIA (as uveitis or as arthritis). Linear and logistic regression with generalized estimating equation (GEE) was performed.

RESULTS: Median age of onset of uveitis was 4.2 years (range 1.5-16). Female-to-male ratio was 3:1. In 15 children (23%) uveitis was diagnosed before arthritis. Visual acuity of boys was significantly worse at 1 and 3 years of follow-up (both P <or= .03) but not at 5 years of follow-up (P = .45). Until 3 years after the diagnosis of uveitis, children with atypical initial manifestation of JIA (uveitis before arthritis) had significantly worse visual acuity compared with children in whom uveitis debuted after arthritis (all P <or= .05). No difference in vision between younger-onset (<7 years) and older-onset (>7 years) groups was noted. Blindness was independently associated with male gender (odds ratio [OR] = 6.61; 95% CI: 1.02-42.98; P = .048).

CONCLUSIONS: Male gender was an independent risk factor for poor visual prognosis in JIA-associated uveitis. Children in whom uveitis is being diagnosed before arthritis have significantly worse vision until 3 years after uveitis onset.

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