Premium
Foveal serous detachment in juvenile idiopathic arthritis(JIA)‐associated uveitis
Author(s) -
LIANG F,
TERRADA C,
DUCOS DE LAHITTE G,
QUARTIER P,
LEHOANG P,
BODAGHI B
Publication year - 2009
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2009.2267.x
Subject(s) - medicine , uveitis , ophthalmology , macular edema , serous fluid , visual acuity
Purpose To characterize the foveal serous detachment(FSD) in JIA‐associated uveitis.To investigate the correlation with visual acuity (VA) and ocular inflammation. Methods 9 children having FSD with JIA‐associated uveitis were identified between 2005‐2007.All were treated with periocular steroid injection and systemic anti‐TNF α antibody.Outcome measures included VA,ocular inflammation quantified by laser flare photometry and the macular profile analyzed by OCT. Results All patients(8 female,1 male) had bilateral uveitis and 6 had bilateral SRD.All patients had risk factors to develop severe anterior uveitis.The mean age at the onset of uveitis and at the onset of FSD was 4.1±1.1years and 7.6±2.2years.At the onset of FSD 6 children were refractory to methotrexate and systemic corticosteroids.It had a high frequency of ocular complications:87% posterior synechiae, 80% cataract, 60% band keratopathy and 20% glaucoma.FSD appeared isolated in 21% of eyes,it was associated with diffuse macular edema in 46% and with cystoid macular edema in 12% of cases.Before therapeutic intensification,the mean VA was 0.46logMAR,the mean foveal thickness(FT) was 261μm.At 6 months follow‐up:VA increased to 0.22logMAR(p=0.017),the reduction of flare was 41%(p=0.003),the mean FT was 229μm(p=0.59).At 12 months follow‐up,the mean VA was 0.19logMAR(p=0.0029),the mean FT was 196μm(p=0.009),only 1 eye showed persistant SRD. Conclusion FSD is a late‐stage complication of sustained and insufficiently treated anterior uveitis in JIA‐associated uveitis and must be considered for the long‐term visual outcome.An agressive immunomodulatory strategy is mandatory in order to achieve strict control of ocular inflammation and improve the visual function.