How frequently should slit lamp screening be performed in patients with Juvenile Idiopathic Arthritis?
Uveitis is commonly detected at the first screening ophthalmology exam. Of JIA patients who develop uveitis, 73% are diagnosed within the first 12 months and 90% by the first 4 years (thus representing the highest risk period). ANA+ status and young age (<7 years old) are risk factors for uveitis. Uveitis does not always track with arthritis disease activity and may manifest when the articular manifestations are in remission.
Here is a table for a suggested screening schedule. It is important to note that this schedule does not apply to a child with established uveiti, in whom regular monitoring is required.
Of note, in 2019 the American College of Rheumatology & the Arthritis Foundation released suggested guidelines for the screening of JIA-associated uveitis.
The Frequency for Slit-lamp Screening in Patients with Juvenile Idiopathic Arthritis
|JIA Category||<7 years At Disease Onset||≥7 years at Disease Onset|
RF– polyarthritis (if ANA+)
|Every 3 months for 4 years, then every 6 months for 3 years, then yearly||Every 6 months for 2 years, then yearly|
|ANA– oligoarthritis||Every 6 months for 4 years, then yearly||Yearly|
ANA, antinuclear antibody; JIA, juvenile idiopathic arthritis; oligo, oligoarticular; poly, polyarticular; RF , rheumatoid factor.