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Update on the Treatment of Uveitis in Patients with Juvenile Idiopathic Arthritis: A Review

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Abstract

Chronic uveitis is a common extra-articular manifestation of juvenile idiopathic arthritis. The classic clinical picture is one of chronic anterior uveitis, which usually remains asymptomatic until ocular complications arise. The risk of uveitis is increased in girls with an early onset of oligoarthritis and positive antinuclear antibodies. Even though the inflammation in patients with juvenile idiopathic arthritis is initially limited in the anterior part of the eye, chronic active inflammation may eventually cause significant damage to the posterior pole. Complications may include band keratopathy, cataract, secondary glaucoma, posterior synechiae, cystoid macular edema, and hypotony. The cooperation of ophthalmologists with rheumatologists may help define the best treatment plan. The ophthalmic therapeutic regimen includes topical corticosteroids and mydriatics, while in severe cases immunosuppressive and biological agents are introduced. Surgical management of complications might be needed.

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Acknowledgements

No funding or sponsorship was received for the publication of this article. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published. No assistance with medical writing or editing was received for this paper.

Disclosures

Ioannis Asproudis, Alexandra Tantou and Nikolaos Kozeis have nothing to disclose. Andreas Katsanos has received honorariums from Allergan, Novartis and Vianex and had congress and travel expenses covered by Vianex and Laboratoires Thea. Anastasios GP Konstas has received honorariums from (and is a consultant for) Alcon, Allergan, Mundipharma, and Santen and had congress and travel expenses covered by MSD/Vianex.

Compliance with Ethics Guidelines

This article is based on previously conducted studies, and does not involve any new studies of human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Ioannina, Ioannina, Greece

    Ioannis Asproudis, Andreas Katsanos & Alexandra Tantou

  2. Ophthalmica Institute, Thessaloniki, Greece

    Nikolaos Kozeis

  3. 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Anastasios G. Konstas

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  1. Ioannis Asproudis
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  2. Andreas Katsanos
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Correspondence to Andreas Katsanos.

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Asproudis, I., Katsanos, A., Kozeis, N. et al. Update on the Treatment of Uveitis in Patients with Juvenile Idiopathic Arthritis: A Review. Adv Ther 34, 2558–2565 (2017). https://doi.org/10.1007/s12325-017-0635-3

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