Juvenile Idiopathic Arthritis (JIA) Associated Uveitis (JIA-U) remains one of the most serious complications of JIA in children. Historically, pediatric JIA is diagnosed by an Optometrist or Ophthalmologist; however, barriers to scheduling increase wait times that may delay diagnosis and treatment. The purpose of this study was to evaluate laser flare photometry (LFP) use to diagnose JIA-U in the Pediatric Rheumatology clinic for patients with JIA. This prospective, observational study assessed pediatric patients diagnosed with JIA without a previous history of uveitis between January 2020 and September 2022. All patients underwent at least one evaluation of both eyes using a Kowa FM-600 laser flare photometer during a routine Rheumatology appointment, as well as a standard slit lamp examination (SLE) by optometry or ophthalmology during routine clinical care. Data collected at patient visits included demographics, JIA characteristics, treatment, LFP readings, and anterior chamber (AC) cell grade score utilizing the SUN grading system. Data were summarized using descriptive analyses and the uveitis false positive rate was calculated. The study cohort included 58 pediatric patients diagnosed with JIA. The mean age was 8.4 years (1.2–16.3 years) at diagnosis and 11.9 (4.8–16.5 years) at enrollment. The mean duration of disease at time of enrollment was 42 months (range; 0-157 months). Participants were predominantly female (n = 43, 74.1%) and white/Caucasian race (n = 37, 63.8%). The most common JIA subtypes included persistent oligoarticular JIA (n = 19, 32.8%), and RF negative polyarticular JIA (n = 12, 20.7%). There were 12 ANA positive patients (20.7%). At enrollment, 16 patients (27.6%) were not on medications, with 20 (34.5%) on methotrexate, 20 (34.5%) on adalimumab, 6 (10.3%) on tocilizumab, and 5 (8.6%) on etanercept. During the study period, no eye exams detected active uveitis based on SLE with a SUN grade over 0. However, of the 135 LFP readings, 131 (97.0%) were normal, yielding a false positive rate of 3% (95% CI: 0.8%, 7.4%). LFP is a non-invasive tool that can be utilized in the pediatric rheumatology clinic to evaluate for JIA-U. There is a low false positive rate of LFP when compared with standard slit lamp exam.

中文翻译：

---

在儿科风湿科办公室用激光耀斑光度测定法筛查幼年特发性关节炎相关葡萄膜炎：一项前瞻性观察研究

幼年特发性关节炎 (JIA) 相关葡萄膜炎 (JIA-U) 仍然是儿童 JIA 最严重的并发症之一。历史上，小儿幼年特发性关节炎是由验光师或眼科医生诊断的。然而，预约的障碍增加了等待时间，可能会延误诊断和治疗。本研究的目的是评估激光耀斑光度测定法 (LFP) 在儿科风湿病诊所诊断 JIA-U 患者中的应用。这项前瞻性观察性研究评估了 2020 年 1 月至 2022 年 9 月期间诊断为幼年特发性关节炎且无葡萄膜炎病史的儿科患者。所有患者在常规风湿科预约期间均使用 Kowa FM-600 激光耀斑光度计对双眼进行了至少一次评估，如下：以及在常规临床护理期间通过验光或眼科进行的标准裂隙灯检查 (SLE)。患者就诊时收集的数据包括人口统计、JIA 特征、治疗、LFP 读数以及利用 SUN 分级系统的前房 (AC) 细胞等级评分。使用描述性分析总结数据并计算葡萄膜炎假阳性率。该研究队列包括 58 名被诊断患有 JIA 的儿童患者。诊断时的平均年龄为 8.4 岁（1.2-16.3 岁），入组时的平均年龄为 11.9 岁（4.8-16.5 岁）。入组时的平均病程为 42 个月（范围：0-157 个月）。参与者主要为女性（n = 43，74.1%）和白人/高加索人种（n = 37，63.8%）。最常见的 JIA 亚型包括持续性少关节 JIA（n = 19，32.8%）和 RF 阴性多关节 JIA（n = 12，20.7%）。ANA 阳性患者 12 例（20.7%）。入组时，16 名患者 (27.6%) 未接受药物治疗，其中 20 名患者 (34.5%) 接受甲氨蝶呤治疗，20 名患者 (34.5%) 接受阿达木单抗治疗，6 名患者 (10.3%) 接受托珠单抗治疗，5 名患者 (8.6%) 接受依那西普治疗。在研究期间，没有眼科检查发现基于 SLE 且 SUN 等级超过 0 的活动性葡萄膜炎。然而，在 135 个 LFP 读数中，131 个 (97.0%) 正常，假阳性率为 3%（95% CI： 0.8%, 7.4%）。LFP 是一种非侵入性工具，可用于儿科风湿病诊所评估 JIA-U。与标准裂隙灯检查相比，LFP 的假阳性率较低。