PREVALENCE OF UVEITIS IN AN OUTPATIENT JUVENILE ARTHRITIS CLINIC - ONSET OF UVEITIS MORE THAN A DECADE AFTER ONSET OF ARTHRITIS

Purpose: To determine the prevalence and severity of uveitis in an out patient pediatric arthritis clinic in the midwestern United States dur ing the 1990s. Methods: The prevalence and clinical characteristics of uveitis were studied retrospectively for all children diagnosed with arthritis at Shriner's Hospital for Crippled Children and followed by the pediatric rheumatology and ophthalmology units of the St Louis Chi ldren's Hospital between 1992 and 1995. Results: Seven children (9%) d eveloped uveitis in a population of 78 patients with juvenile arthriti s. Six of the seven children were female, and all six females had anti nuclear antibody (ANA)-positive, juvenile rheumatoid arthritis (JRA). The prevalence of anterior uveitis in females with ANA-positive, pauci articular JRA was 20%, and in polyarticular JRA, 17%, One of the girls with uveitis had combined JRA and sarcoidosis; the boy with uveitis h ad juvenile spondylitis. Arthritis preceded the onset of uveitis in ea ch child by 1 to 13 years (average, 6.4 years). Progression of the uve itis in three of the children resulted in band keratopathy and catarac t, causing significant visual loss in two (ie, in 29% of the children who developed uveitis). Conclusion: The prevalence and ocular morbidit y of uveitis in juvenile arthritis appears to have remained relatively stable over the last 2 decades. Onset of the uveitis in several of th e children in our study population occurred more than a decade after t he diagnosis of arthritis. Girls with ANA-positive JRA and boys with j uvenile spondylitis may need to be followed by periodic slit-lamp exam ination for longer periods than recommended previously.