Screening for asymptomatic JIA-associated anterior uveitis
Most children and adolescents with juvenile idiopathic arthritis (JIA) require regular screening for anterior uveitis. The exception is children or adolescents with enthesitis-related arthritis because they develop acute symptomatic anterior uveitis, identifiable by ocular pain and redness.
The screening interval for asymptomatic anterior uveitis in children and adolescents with JIA depends on patient factors, including:
- the form of JIA (eg patients with oligoarticular JIA have a high risk, whereas patients with systemic JIA have a very low risk)
- age at onset of disease
- antinuclear antibody (ANA) status (a positive ANA titre confers higher risk).
Children with ANA-positive oligoarthritis or ANA-positive polyarthritis with an onset at 6 years of age or younger should be screened every 3 months for the first 4 years of their disease course; the frequency of screening is gradually reduced so that after 7 years of disease, screening occurs annually. Other children and adolescents with JIA, except those with enthesitis-related arthritis, typically require review every 6 to 12 months until 10 to 12 years of age.