Severe Macular Edema in Patients with Juvenile Idiopathic Arthritis-Related Uveitis

Abstract

Purpose . To report the onset of severe macular edema in adolescent female patients affected by juvenile idiopathic arthritis (JIA). Methods . Four female patients affected by JIA-related chronic anterior uveitis (CAU), complicated by severe macular edema, were retrospectively analyzed. Macular area was evaluated by fluorescein angiography and optical coherence tomography (OCT). Results . CAU was bilateral in three patients. Mean age of uveitis and arthritis onset was, respectively, 4.5±1.7 years and 6.0±3.9 years. All patients underwent cataract extraction surgery. Despite ocular inflammation being controlled by topical/systemic therapy, during adolescence (mean age of appearance/diagnosis: 12.7±3.9 years) patients developed severe unilateral macular edema. OCT revealed massive macular thickening (range from 550 μ m to 1214 μ m). Conclusions . Macular edema appeared in female adolescent patients in eyes with long-dating CAU submitted to cataract surgery. In such patients, in presence of age-related microvascular changes due to the enhancer effect of sex hormones, cataract extraction should be a factor triggering the retinal complication.