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Uveitis Associated with Juvenile Idiopathic Arthritis

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Practical Management of Pediatric Ocular Disorders and Strabismus

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Abstract

Juvenile idiopathic arthritis (JIA) is the most common systemic disease causing uveitis in childhood, with a prevalence of 10 per 100,000 persons. JIA often takes a severe inflammatory course, and its complications often endanger vision. Regular ophthalmologic examinations should be performed starting as soon as JIA is diagnosed. Of the patients who develop uveitis associated with JIA, 75–80 % of patients are females and antinuclear antibodies are found in 70–90 %. The risk for vision loss is higher if uveitis begins in the preschool years. Severely affected patients should be treated in tertiary centers by uveitis specialists to optimize their long-term outcome. Multidisciplinary, individualized treatment is needed because of the chronic course of active inflammation and the ensuing high risk of complications that can endanger vision. Topical corticosteroids should be given as the initial treatment. Systemic immunosuppression is needed if inflammation persists despite topical corticosteroids, if new complications arise, or if the topical steroids have to be given in excessively high doses or have unacceptable side effects. If the therapeutic effect remains inadequate, conventional and biological immune modulators can be given in a stepwise fashion until therapeutic response is attained. Treatment lowers the risk of uveitis and its complications and thereby improves the prognosis for good visual function.

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Author information

Authors and Affiliations

  1. San Giuseppe Hospital-University Eye Clinic, Milan, 20123, Italy

    Francesco Pichi M.D. & Paola Carrai MD

  2. Cole Eye Institute, Cleveland Clinic, Cleveland, OH, 44106, USA

    Careen Lowder MD, PhD

Authors
  1. Francesco Pichi M.D.
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  2. Paola Carrai MD
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  3. Careen Lowder MD, PhD
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Correspondence to Careen Lowder MD, PhD .

Editor information

Editors and Affiliations

  1. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Elias Traboulsi

  2. Abrahamson Pediatric Eye Institute, Cincinnati Children's Hospital, Cincinnati, Ohio, USA

    Virginia Utz

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Pichi, F., Carrai, P., Lowder, C. (2016). Uveitis Associated with Juvenile Idiopathic Arthritis. In: Traboulsi, E., Utz, V. (eds) Practical Management of Pediatric Ocular Disorders and Strabismus. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2745-6_22

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  • DOI: https://doi.org/10.1007/978-1-4939-2745-6_22

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-2744-9

  • Online ISBN: 978-1-4939-2745-6

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