Time of onset of iridocyclitis (IC) in children with juvenile idiopathic arthritis (JIA)

Background

IC is one of the most important extra-articular complications of JIA. However, little information exists on the time of onset of IC during the disease course.

Objective

To evaluate the frequency of IC onset over time in JIA patients who developed this complication.

Methods

1050 JIA patients seen between 1985 and 2007 were identified. 172 patients (16.4%) had IC. 6 patients with enthesitis-related arthritis with acute IC, 4 patients who developed IC before arthritis onset and 2 patients in whom date of IC onset was unknown were excluded. Of the remaining 160 patients, 108 (67.5%) had oligoarthritis, 36 (22.5%) RF-negative polyarthritis, 9 (5.6%) undifferentiated arthritis, 6 (3.8%) psoriatic arthritis, 1 (0.6%) systemic arthritis. Of the 158 patients who had ANA tested, 144 (91.1%) were positive (≥ 1:160), 8 (5.1%) low-positive (≤ 1:80) or doubtful, 6 (3.8%) negative.

Results

The cumulative proportion of patients who developed IC over time is shown in figure 1 and table 1.

Figure 1

Table 1

Conclusion

Of 160 patients who had IC, half developed this complication in the first year, 2/3 in the first 2 years, 4/5 in the first 3 years, and only 5.6% after 7 years. This suggests that risk of IC onset is greatest in the first 3 years of disease and that the optimal time for reducing the frequency of ophthalmologic visits is 7 years after onset.