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Background <p>Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Uveitis is the most frequent extra-articular manifestation of JIA and a major cause of visual morbidity. Despite advances in immunomodulatory therapy, many patients reach adulthood with active ocular inflammation or vision-threatening complications. The transition from pediatric to adult care represents a vulnerable period. The primary objective of our study is to describe ophthalmologic and rheumatologic disease characteristics at the time of transition from pediatric to adult care.</p> Methods <p>We conducted a retrospective cohort study of patients with JIA and past or present uveitis who transitioned to adult rheumatology at Cochin Hospital between 2016 and 2024. Clinical, ophthalmologic, and therapeutic data were collected from electronic medical records. Descriptive statistics were performed. Comparative analyses were exploratory and intended to describe differences between subgroups rather than to test predefined hypotheses.</p> Results <p>A total of 46 patients were included. Median age at JIA diagnosis was 7.5 years [IQR 2.0–16.0] and median age at first uveitis was 6.0 years [IQR 3.0–12.2]. Median follow-up after transition was 2.44 years [IQR 1.17–3.94]. Most patients were female (80%, <i>n</i> = 37) and had oligoarticular JIA (59%, <i>n</i> = 27). Chronic uveitis predominated (83%, <i>n</i> = 38). Ocular complications occurred in 46% (<i>n</i> = 17), including cataract (24%, <i>n</i> = 11), glaucoma (20%, <i>n</i> = 9), and keratitis (7%, <i>n</i> = 3). Over half (57%, <i>n</i> = 13/23) experienced ≥ 5 flares since diagnosis. Biologic DMARDs were prescribed in 53% (<i>n</i> = 23/43), predominantly anti-TNF agents.</p> Conclusion <p>This study highlights the substantial burden of JIA-associated uveitis at the time of transition to adult care, characterized by frequent complications, persistent disease activity, and a high need for biologic therapy. Our findings emphasize the necessity of structured and continuous ophthalmologic follow-up across all JIA subtypes, alongside close multidisciplinary collaboration, to prevent long-term ocular damage and preserve visual function.</p>

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Characteristics of JIA-associated uveitis at the age of transition

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月19日

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  • Anna Raymond,
  • Alice Combier,
  • Sophie Hecquet,
  • Dominique Monnet,
  • Fatam El Fakih,
  • Julien Wipff,
  • Gertrude Touanga,
  • Pierre Quartier,
  • Yannick Allanore,
  • Marion Thomas

摘要

Background

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children. Uveitis is the most frequent extra-articular manifestation of JIA and a major cause of visual morbidity. Despite advances in immunomodulatory therapy, many patients reach adulthood with active ocular inflammation or vision-threatening complications. The transition from pediatric to adult care represents a vulnerable period. The primary objective of our study is to describe ophthalmologic and rheumatologic disease characteristics at the time of transition from pediatric to adult care.

Methods

We conducted a retrospective cohort study of patients with JIA and past or present uveitis who transitioned to adult rheumatology at Cochin Hospital between 2016 and 2024. Clinical, ophthalmologic, and therapeutic data were collected from electronic medical records. Descriptive statistics were performed. Comparative analyses were exploratory and intended to describe differences between subgroups rather than to test predefined hypotheses.

Results

A total of 46 patients were included. Median age at JIA diagnosis was 7.5 years [IQR 2.0–16.0] and median age at first uveitis was 6.0 years [IQR 3.0–12.2]. Median follow-up after transition was 2.44 years [IQR 1.17–3.94]. Most patients were female (80%, n = 37) and had oligoarticular JIA (59%, n = 27). Chronic uveitis predominated (83%, n = 38). Ocular complications occurred in 46% (n = 17), including cataract (24%, n = 11), glaucoma (20%, n = 9), and keratitis (7%, n = 3). Over half (57%, n = 13/23) experienced ≥ 5 flares since diagnosis. Biologic DMARDs were prescribed in 53% (n = 23/43), predominantly anti-TNF agents.

Conclusion

This study highlights the substantial burden of JIA-associated uveitis at the time of transition to adult care, characterized by frequent complications, persistent disease activity, and a high need for biologic therapy. Our findings emphasize the necessity of structured and continuous ophthalmologic follow-up across all JIA subtypes, alongside close multidisciplinary collaboration, to prevent long-term ocular damage and preserve visual function.