%0 Journal Article
%T Severe Macular Edema in Patients with Juvenile Idiopathic Arthritis-Related Uveitis
%A Maria Pia Paroli
%A Claudia Fabiani
%A Giovanni Spinucci
%A Irene Abicca
%A Alfredo Sapia
%A Leopoldo Spadea
%J Case Reports in Ophthalmological Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/803989
%X Purpose. To report the onset of severe macular edema in adolescent female patients affected by juvenile idiopathic arthritis (JIA). Methods. Four female patients affected by JIA-related chronic anterior uveitis (CAU), complicated by severe macular edema, were retrospectively analyzed. Macular area was evaluated by fluorescein angiography and optical coherence tomography (OCT). Results. CAU was bilateral in three patients. Mean age of uveitis and arthritis onset was, respectively, years and years. All patients underwent cataract extraction surgery. Despite ocular inflammation being controlled by topical/systemic therapy, during adolescence (mean age of appearance/diagnosis: years) patients developed severe unilateral macular edema. OCT revealed massive macular thickening (range from 550£¿¦Ìm to 1214£¿¦Ìm). Conclusions. Macular edema appeared in female adolescent patients in eyes with long-dating CAU submitted to cataract surgery. In such patients, in presence of age-related microvascular changes due to the enhancer effect of sex hormones, cataract extraction should be a factor triggering the retinal complication. 1. Introduction Eye involvement in juvenile idiopathic arthritis (JIA) is frequent: typically the uveitis is a chronic, bilateral, and nongranulomatous anterior uveitis with insidious and asymptomatic course. Macular edema is one of the most sight-threatening complications, ranging from 3% to 47% [1]. It is reported that macular edema is the cause of legal blindness in 8% of children affected by active uveitis [1]. Pathophysiology of inflammatory macular edema is still unclear. The major cause might be the breakdown of the inner blood-retinal barrier. Microvascular factors are involved and probably enhanced by inflammatory factors and by sex hormones. In our study, we describe four peculiar cases of severe macular edema which appeared during adolescence in JIA female patients affected by chronic anterior uveitis (CAU) from infancy, in which uveitis was under control for a long time. 2. Material and Methods The clinical history of four patients affected by JIA-related uveitis presenting highly severe macular£¿£¿edema was retrospectively analyzed. Fluorescein angiography (FA) and optical coherence£¿£¿tomography (OCT) examination were also performed to determine qualitatively and quantitatively£¿£¿the entity of macular involvement. This study was conducted according to the principles of the£¿£¿Helsinki Declaration and good clinical practices. The following data were collected£¿£¿for each patient: age at first visit, age at onset of uveitis, age at onset of
%U http://www.hindawi.com/journals/criopm/2013/803989/