Background: Juvenile idiopathic arthritis (JIA) is the main cause of chronic uveitis in childhood and JIA associated uveitis (JIA-U) is the most common extraarticular complication of JIA. Despite continuous improvement in its management, pediatric uveitis still represents a serious condition with potential sight-threatening complications and a significant impact on quality of life (QoL).

Objectives: To evaluate visual function (VF) and QoL in children with JIA-U and idiopathic uveitis

Methods: A cross-sectional study was conducted in two tertiary Pediatric Rheumatology Centres, enrolling all patients seen with JIA-U, JIA without uveitis and idiopathic uveitis. VF was assessed by a translated form of the available EYE-Q, adapted for cross-cultural feasibility into a 10-question tool, while QoL was evaluated by the Italian version of the Pediatric Rheumatology Quality of Life scale part of the Juvenile Arthritis Multidimensional Report (JAMAR), shortened for feasibility to a 8-question tool. JAMAR section on treatment compliance and school attendance was also included. Parents, and patients when appropriate, were asked to complete each patient/parent-reporting outcome measure, answering on a 4-point Likert scale, with a total score ranging from 0 to 72 (worst condition). Medical charts were reviewed regarding JIA and uveitis features and outcome. Quantitative and qualitative variables were compared by means of Mann-Whitney U test or chi-square/Fisher exact test, as appropriate; correlations among quantitative non-parametric variables were evaluated by Spearman’s test.

Results: We herein describe results from the first 100 patients enrolled (76% female), with a median age at study time of 12.8 (9.0-17.6) years. Forty-nine had JIA-U, 37 JIA without uveitis and 14 idiopathic uveitis. Uveitis was active in 14/63 patients (22.2%), with a median of uveitis duration of 9.0 years (3.6-14.8). Almost all children with uveitis were on systemic treatment (58/63, 92%) at the time of interview; 54.0% of patients presented an ocular damage, with 8.0% having a best corrected visual acuity (BCVA) < 4/10. Total score, VF and QoL scores resulted significantly higher in JIA-U patients compared to JIA without uveitis, while no differences were noticed among children with uveitis with or without JIA ( Table 1 ). School absence was reported more frequently in JIA-U compared to JIA only (32.7% vs 10.8%, p 0.0211). VF was significantly worse in patients with ocular damage and BCVA < 4/10 (p 0.0351 and 0.0123, respectively). In patients with uveitis, VF and QoL showed a significant correlation (r 0.50, p <0.0001) especially in patients with idiopathic uveitis (r 0.74, p <0.0001).

Conclusion: Visual function is a crucial component of QoL in children with uveitis and it correlates with ocular damage. Since eye involvement significantly affect QoL in patients with JIA, a specific tool widely validated and cross-cultural adapted is highly demanded in the clinical care of JIA-U patients.

REFERENCES:

[1]Angeles-Han ST et al. The importance of visual function in the quality of life of children with uveitis. J AAPOS, 2010. Filocamo et al. A New Approach to Clinical Care of Juvenile Idiopathic Arthritis: The Juvenile Arthritis Multidimensional Assessment Report. J Rheumatol, 2011.

Disclosure of Interests: None declared