Work

Ocular complications in JIA-related uveitis: risk factors and relationship with medication

Year: 2026

Type: article

Abstract: Background Nearly one quarter of the patients with juvenile idiopathic arthritis (JIA) have also JIA-related uveitis (JIA-U). Ocular complications are common in JIA-U, they are associated both to the active inflammation and to the use of topical steroids. JIA-U can ultimately be a sight-threatening comorbidity in JIA. The aim of our study was to evaluate the occurrence of ocular complications in JIA-U and their relationship with the used medication. We also aimed to evaluate possible risk factors for JIA-U complications. Methods This is a real-life non-experimental study. All consecutive patients with JIA-U attending the paediatric rheumatologic clinic in the Hospital District of Helsinki and Uusimaa (HUS) from 2015 to 2022 were included and data from electronic patient records and registry (BCB Medical’s quality register) were collected and analysed retrospectively. Results 71 patients with JIA-U were analysed. The mean age at JIA-U diagnosis was 5.9 years if there were no ocular complications and 4.5 years if complications were present. 62% of the patients had ocular complications during a median follow-up time of 2.9 years. Higher-grade inflammation at the diagnosis of JIA-U was related to ongoing and forthcoming ocular complications. A shorter time between arthritis diagnosis and uveitis diagnosis was also associated with ocular complications. The cumulative events of complications were associated with topical corticosteroid use. Adalimumab seemed to have a protective effect against complications: 52% of those patients who did not develop complications used adalimumab, compared to 9% with complications. Conclusions Despite the biologic era and demonstrated protection with adalimumab, ocular complications still exist in JIA-U. The main findings of our study are that high SUN grading at the time of JIA-U diagnosis, and the length of topical corticosteroid use appears to be related to the occurrence of ocular complications in JIA-U. Furthermore, the use of adalimumab seemed to decrease the occurrence of complications. Alongside the observed protective effect of adalimumab, our results emphasise the importance of appropriate systemic medication. The treatment and follow-up of patients with JIA-U requires co-operation with paediatric rheumatologists and ophthalmologists and a structured follow-up protocol helps to consider risk factors.

Source: Revista Brasileira de Reumatologia

DOI: 10.1186/s42358-026-00577-5

Authors: Katriina Mikola, Sanna Leinonen, Hannu Kautiainen, Tiina Levälampi, Katariina Rebane, Kristiina Aalto