A significant percent of patients with uveitis caused by childhood rheumatic disease continue to suffer from the ocular condition decades later and also exhibited a risk for additional visual problems such as glaucoma and cataracts, a Swedish study presented at the recent ARVO meeting found.

The forty-year follow-up study included patients who had juvenile idiopathic arthritis and were first seen at the Child Rheumatology section of the University Hospital in Lund, Sweden between 1973 and 1982. Of 350 consecutive patients with juvenile idiopathic arthritis, 55 developed uveitis (15.7%). The researchers previously conducted follow ups with the original subjects after seven and 24 years.

In the latest arm of the investigation, researchers reviewed the ophthalmic charts of 30 patients from the last three years. They noted 11 people (20%) from the original investigation had died, although they did not include an investigation of cause of death in their study. The average age of the participants was 47.

Researchers reported the joint diseases started approximately 43 years earlier, and the onset of uveitis began 41 years earlier. The study found 24% of the original cohort still had uveitis.

Of the original 55 patients, 14 eyes developed visual acuity of < 20/200 after 40 years (12%). Additionally, investigators reported 13% of patients had a visual acuity of < 20/200 in the the best eye after 40 years. Of the participating 30 patients, 70% developed cataract and 40% had glaucoma. Out of the original 55 patients, 49% developed cataract and 29% had developed glaucoma 40 years after the start of their uveitis, the study noted.

The researchers also reported approximately 10% of the original participants in the study went blind after 40 years.

“The presence of active uveitis and increasing prevalence of cataract and glaucoma compared to our 24 years follow-up indicates a future risk for increased visual impairment,” the researchers wrote in their abstract. This data is unique and can be valuable as a comparison to future long-term studies of this group and could be helpful in more efficient treatments, they added.

The fact that 20% of the patients died before the age of 50 is also striking and will be further investigated, researchers noted.

Skarin A, Rauer O, Bengtsson-Stigmar E. A forty years follow-up study of patients with uveitis associated with juvenile idiopathic arthritis (JIA). ARVO 2019. Abstract 6685.