Results 5 to 10 years after cataract surgery with primary IOL implantation in juvenile idiopathic arthritis-related uveitis.

PURPOSE: To evaluate the results of cataract extraction with primary intraocular lens (IOL) implantation in patients with juvenile idiopathic arthritis (JIA) and uveitis-related cataract. SETTING: Department of Ophthalmology, Helsinki University Hospital, Finland. DESIGN: Retrospective case series. METHODS: All consecutive patients younger than 20 years with JIA-uveitis-related cataract undergoing cataract extraction with primary IOL implantation in 1 or both eyes at the Department of Ophthalmology, Helsinki University Hospital, Finland, from February 2000 to April 2012 were included. Twenty eligible patients with 26 operated eyes were identified; 14 were girls and 6 were boys. All patients had a follow-up of 5 years and 13 patients (16 eyes [65%]) reached 10 years of follow-up. RESULTS: Twenty-six eyes of 20 patients were studied. Preoperative median corrected distance visual acuity (CDVA) was 0.05 in decimal notation. Median CDVA was 1.0 at 5 years and 0.9 at 10 years of follow-up. Two eyes did not reach CDVA 0.5 with the operation, and in 2 eyes, CDVA decreased below 0.5 over the period of 3 to 5 years after the operation. Active uveitis during 3 and 12 months preoperatively was a risk indicator for postoperative CDVA <0.5 at 5 years (P = .005 and P = .007, respectively). CONCLUSIONS: Cataract extraction with primary IOL implantation provides long-standing good visual acuity for young patients with well-controlled JIA-related uveitis.

Anti-adalimumab antibodies in juvenile idiopathic arthritis-related uveitis.

OBJECTIVES: To evaluate the association of adalimumab trough levels and anti-adalimumab antibodies with activity of uveitis in juvenile idiopathic arthritis-related uveitis. METHODS: This was a retrospective observational case series in a clinical setting at the Department of Ophthalmology, Helsinki University Hospital, Finland in 2014-2016. Thirty-one paediatric patients with chronic anterior juvenile idiopathic arthritis-related uveitis in 58 eyes and who had been on adalimumab ≥6 months were eligible for the study. Uveitis activity during adalimumab treatment, adalimumab trough levels and anti-adalimumab antibody levels were recorded. RESULTS: Anti-adalimumab antibody levels ≥12 AU /ml were detected in nine patients (29%). This level of anti-adalimumab antibodies was associated with a higher grade of uveitis (p<0.001), uveitis that was not in remission (p=0.001) and with lack of concomitant methotrexate therapy (p=0.043). In patients with anti-adalimumab antibody levels <12 AU/ml, higher serum trough levels did not associate with better control of uveitis (p=0.86). CONCLUSIONS: Adalimumab treatment might be better guided by monitoring anti-adalimumab antibody formation in treating JIA-related uveitis.

An evaluation of dry eye symptoms and signs in a cohort of children with juvenile idiopathic arthritis.

OBJECTIVE: To determine the prevalence of dry eye symptoms and signs in children with juvenile idiopathic arthritis (JIA). PATIENTS AND METHODS: A total of 192 children with JIA: 48 oligo-, 39 extended oligo-, 79 polyarthritis, and 26 with other types of arthritis (eight juvenile spondyloarthritis, five juvenile psoriatic arthritis, three mixed connective tissue diseases, two systemic onset arthritis, and eight undetermined arthritis) were interviewed for dry eye symptoms and tested with Schirmer test with anesthetic. Two thirds of the patients were female and the mean age of the patients was 13.1 years (range 10-16) and the mean duration of arthritis was six years (SD 4, 4). Thirty-one percent of the patients had a history of uveitis. Dry eye was defined as Schirmer test score