Clinical Characteristics and Prognosis of Juvenile Idiopathic Arthritis-Associated Uveitis: A Single-Center Retrospective Study

Abstract

Objective: To characterize the clinical features, risk factors, and outcomes of juvenile idiopathic arthritis-associated uveitis (JIA-U), aiming to improve early detection and management strategies. Methods: This study conducted a retrospective cohort analysis of JIA patients diagnosed and treated at the Department of Rheumatology at Beijing Children’s Hospital (2016–2023), with subgroup evaluation of JIA-U cases. Results: Among 1494 JIA patients, 72 (4.82%) developed uveitis. The oligoarticular subtype (OJIA, 47.2%) and enthesitis-related arthritis (ERA, 27.8%) predominated. Uveitis onset occurred at a median of 10 months post-arthritis diagnosis (range: 0–86 months), with 93% manifesting within 4 years. Chronic anterior uveitis was the most frequent phenotype. ANA positivity and HLA-B27 were significantly associated uveitis. First-line acute management involved topical corticosteroids, with methotrexate escalation for severe cases and TNF-α inhibitors (adalimumab preferred) for refractory disease. Ocular complications arose in 25.9% during follow-up. Conclusion: Uveitis, often bilateral and insidious, is a common extra-articular manifestation of JIA. Absent arthritis signs may delay diagnosis, highlighting the need for regular screening and close rheumatology–ophthalmology collaboration to optimize outcomes.