Progress in monitoring inflammation in JIA

Purpose To analyze the most appropriate strategy to monitor ocular inflammation in children with juvenile idiopathic arthritis ‐ associated uveitis. Methods Slit lamp biomicroscopy is widely used to evaluate the importance of anterior segment flare and cells in children with anterior uveitis. However, different studies have clearly shown that other tools such as laser flare photometry and OCT may improve the monitoring during the follow‐up. Therefore, both tests are performed in all children referred to our Department for the management of JIA‐associated uveitis. Results Laser flare photometry showed for the first time that active ocular inflammation may be associated with a significant level of flare even in the absence of detectable cells. This is a major finding to start a therapeutic approach or change it for a more aggressive strategy and monitor the decrease of flare. Moreover, the level of flare decrease under therapy may predict further serious complications such as secondary glaucoma or cataract. OCT features are important to identify macular alterations in nearly 85% of children with anterior uveitis associated with JIA. Conclusion Both laser flare photometry and OCT are non invasive and quantitative methods that may significantly improve the visual outcome of JIA‐associated uveitis.