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TitelManagement of Juvenile Idiopathic Arthritis
DoelChildren with JIA present a complex set of management issues when requiring surgery for ocular complications. Outcomes are generally limited. Does aggressive medical and surgical management improve outcomes?
MethodesA retrospective review of the outcomes (vision, therapy, complications) in patients managed with an intense regiment of methotrexate, +/- steroids, +/- biologics. Surgery was planned based on need but consisted in a complete pars plana vitrectomy with ciliary body shaving, ILM peel, and where appropriate an intraocular lens implant. If no implant was placed, the capsule was removed.
ResultatenAll patients had improvement in vision. Only one eye lost significant vision during an episode of hypotony following a reduction in the anti-inflammatory medications 24 months after surgery. Median vision prior to surgery was 0.05. At one year, median vision was 0.6.
ConclusieIn JIA aggressive management both medical and surgical improves the visual outcome. However, long term medical treatment is required even after successful surgery.
Auteur 1
Naamde SMET
InitialenMD
InstituutUniversity of Amsterdam; ZNA Middeleheim Campus
StadAmsterdam ; Antwerp
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