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Vol. 11. Issue 3.
Pages 133-138 (May - June 2015)
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Vol. 11. Issue 3.
Pages 133-138 (May - June 2015)
Special article
DOI: 10.1016/j.reumae.2014.12.005
The Importance of an Ophthalmologic Examination in Patients With Juvenile Idiopathic Arthritis
Importancia de la evaluación oftalmológica en pacientes con artritis idiopática juvenil
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Alejandro Rodríguez-García
Servicio de Inmunología Ocular y Uveítis, Instituto de Otalmología y Ciencias Visuales, Escuela de Medicina y Ciencias de la Salud, TEC Salud, Tecnológico de Monterrey, Monterrey, Nuevo León, Mexico
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Tables (3)
Table 1. Classification of JIA According to the International League of Associations for Rheumatology (ILAR).
Table 2. Ocular Complications Most Frequently Reported in Patients With Uveitis Associated With JIA.
Table 3. Suggested Intervals for Ophthalmic Screening of Patients With JIA According to the Classification Criteria of the International League of Associations for Rheumatology (ILAR).
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Abstract

Uveitis occurs within the first year of arthritis onset in 73% of patients with juvenile idiopathic arthritis (JIA) considered at risk. The intraocular inflammation is characterized by an insidious onset and a silent and chronic clinical course capable of producing significant visual loss due to complications such as: cataract formation, secondary glaucoma, maculopathy and optic neuropathy. The absence of initial signs and symptoms, along with a deficient ophthalmic monitoring produces a delay in diagnosis with serious consequences. It has been estimated that 47% of JIA patients at risk for developing uveitis are legally blind (20/200 or worse) at least in one eye at the time of their first visit to the ophthalmologist. To reduce ocular complications and improve their visual outcome, it is necessary that rheumatologists refer all patients recently diagnosed (within the first month) with JIA for an ophthalmic evaluation, and maintain periodical follow-up visits based on classification and risk category of the disease.

Keywords:
Juvenile idiopathic arthritis
Uveitis
Cataract
Glaucoma
Blindness
Resumen

La uveítis ocurre dentro del primer año del inicio de la artritis en hasta el 73% de los pacientes con artritis idiopática juvenil (AIJ) considerados en riesgo. La inflamación intraocular se caracteriza por un inicio insidioso y un curso clínico silencioso y crónico, capaz de producir pérdida visual significativa debido a complicaciones como: formación de cataratas, glaucoma, maculopatía y neuropatía óptica. La ausencia de signos y síntomas oculares iniciales, aunado a una deficiente monitarización oftalmológica, producen un retraso diagnóstico de graves consecuencias. Se ha reportado ceguera legal (20/200 o peor) en al menos un ojo en hasta el 47% de aquellos pacientes en riesgo para desarrollar uveítis durante la primera visita oftalmológica. Para reducir las complicaciones oculares y mejorar el pronóstico visual, es necesario referir inmediatamente a pacientes recién diagnosticados con AIJ por el reumatólogo a evaluación oftalmológica y mantener visitas periódicas de seguimiento basadas en la clasificación y la categoría de riesgo de la enfermedad.

Palabras clave:
Artritis idiopática juvenil
Uveítis
Catarata
Glaucoma
Ceguera

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