Li Li, Jun-Mei Zhang, Jiang-Hong Deng, Wei-Ying Kuang, Xiao-Hua Tan, Chao Li, Shi-Peng Li, Cai-Feng Li

Department of Rheumatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, People’s Republic of China

Correspondence: Cai-Feng Li, Department of Rheumatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Nan Li Shi Road no. 56, Beijing, 100045, People’s Republic of China, Email caifeng_li@yeah.net

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.

Keywords: juvenile idiopathic arthritis, uveitis, clinical manifestations, treatment, prognosis