Visual Function And Quality Of Life In A Cohort Of Swedish Children With Juvenile Idiopathic Arthritis

Figures & data

Table 1 Demographic Data On 40 Children With Juvenile Idiopathic Arthritis (JIA) Divided Into Those With JIA-Associated Uveitis (n = 7) Or Not (n = 33)

Demographics	JIA children n = 40*	Uveitis n = 7*	No uveitis n = 33*
Age at assessment (yrs)
Mean (range)	7.9 (3.111.8)	7.9 (4.211.0)	7.8 (3.111.8)
Gender, n (%)
Male	9 (22.5%)	2 (29%)	7 (21%)
Female	31 (77.5%)	5 (71%)	27 (79%)
Race, n (%)
Caucasian	40 (100%)	7 (100%)	33 (100%)
JIA disease characteristics
Age at JIA diagnosis (yrs) Mean (range)	3.7 (0.411.3)	3.3 (1.55.3)	3.8 (1.411.3)
Duration of JIA (yrs) Mean (Range)	4.2 (0.79)	4.9 (1.68.3)	4.1 (0.79)
JIA subtype, n (%)
Systemic	1 (2.5%)	0	1 (3%)
Oligoarthritis persistent	25 (62.5%)	4 (57%)	21 (64%)
Oligoarthritis extended	5 (12.5%)	1 (14%)	4 (12%)
Psoriatic	1 (2.5%)	0	1 (3%)
Polyarthritis	8 (20%)	2 (29%)	6 (18%)
Labs, n (%)
ANA (+)	26 (65%)	5 (71%)	21 (64%)
RF (–)	26 (100%) n = 26	3 (100%) n = 3	23 (100%) n = 23
HLA B27 (+)	3 (100%) n = 3	0	3 (100%) n = 3

Notes: *Where numbers differ from the total number of children in the group, they are given separately for each category.

Abbreviations: ANA, antinuclear antibodies; HLA B27, human leukocyte antigen subtype B27; JIA, juvenile idiopathic arthritis; n, number of children; RF, rheumatic factor.

Table 2 Characteristics Of Children With Juvenile Idiopathic Arthritis (JIA)-Associated Uveitis At Study Enrolment

	Patient No 1	Patient No 2	Patient No 3	Patient No 4	Patient No 5	Patient No 6	Patient No 7
Age at assessment (yrs)	8	4.2	8.1	9.1	6.2	8.8	11
Sex m/f	f	f	f	f	m	m	f
JIA debut (yrs)	1.5	1.5	4.5	2.8	4.5	3	5.3
ANA (±)	+	–	+	+	+	–	+
JIA subtype	Oligoarthritis persistent	Polyarthritis	Polyarthritis	Oligoarthritis extended	Oligoarthritis persistent	Oligoarthritis persistent	Oligoarthritis persistent
Age at uveitis diagnosis (yrs)	3.7	4.2	4.9	5	4.7	6.8	5.4
Interval between uveitis and arthritis (yrs)	1.7	2.7	0.4	2.2	0.2	3.8	0.1
Bilateral involvement (Y/N)	Y	N	Y	Y	Y	N	N
Location uveitis	Anterior	Anterior	Anterior	Anterior	Anterior	Anterior	Anterior
BCVA best eye (LogMAR)	−0.1	0.1	0.4	0.0	0.0	0.0	−0.1
VA RE	1.0	0.8	0.4	1.0	1.0	1.0	1.25
VA LE	1.3	0.65	0.4	1.0	1.0	1.0	1.25
Ocular complication(s)	Synechiae, ocular hypertension		Bilateral band keratopathy and synechiae, cataract*, ocular hypertension				Unilateral subcapsular cataract
Current treatment	Methotrexate^® Adalimumab,	Etanercept^®, ocular local	Methotrexate^® Adalimumab^® Betoptic S^® Dexamethasone^®, ocular local		Adalimumab	Methotrexate^®

Note: *This child had underwent cataract surgery.

Abbreviations: ANA, antinuclear antibodies; BCVA, best corrected visual acuity; JIA, juvenile idiopathic arthritis; LogMAR, logarithm of the minimum angle of resolution; N, no; VA, visual acuity; Y, yes.

Table 3 Visual Acuity And Refraction In 40 Children With Juvenile Idiopathic Arthritis (JIA) Compared With An Age- And Sex-Matched Control Group (n = 55)

Visual Acuity (logMAR)	JIA Children, n = 40*	Uveitis, n = 7	No Uveitis, n = 33*	Uveitis Vs No Uveitis p-value	Controls, n = 55	JIA vs Control p-Value	Uveitis vs Control p-Value	No Uveitis vs Control p-Value
BCVA best eye MeanSD	0.0150.108	0.0290.170	0.0120.093	0.76	0.0270.091	0.19	0.30	0.28
VA RE MeanSD	0.0230.111 n = 39	0.0570.162	0.0160.099 n = 32	0.61	0.0370.096	0.16	0.79	0.14
VA LE Mean (SD)	0.0360.116 n = 39	0.0860.168	0.0250.102 n = 32	0.41	0.0380.088	0.43	0.74	0.30
Refraction** D SE
RE MeanSD	+0.0631.479 n = 38	−0.411	+0.169 n = 31	0.56
LE Mean SD	+0.24 n = 37	−0.286	+0.363 n = 30	0.42
Refractive error n (%)
Myopia (≥0.5 D SE)	16 (42%) n = 38	4	12 (39%) n = 31	0.43
Hyperopia (≥2.0 D SE)	5 (13%) n = 38	1	4 (13%) n = 31	1.00
Astigmatism (≥0.75 D)	4 (11%) n = 38	2	3 (10%) n = 31	0.21
Anisometropia (≥1.0 D SE)	5 (13%) n = 38	2	3 (10%) n = 31	0.21

Notes: *Where numbers differ from the total number of children in the group, they are given separately for each category. **Undilated.

Abbreviations: BCVA, best corrected visual acuity; JIA, juvenile idiopathic arthritis; D, dioptre; IOP, intraocular pressure; LE, left eye; LogMAR, logarithm of the minimum angle of resolution; n, number of children; RE, right eye; SD, standard deviation; SE, spherical equivalent; VA, visual acuity.

Table 4 Effects Of Youngsters’ Eyesight On Quality Of Life Questionnaire (EYE-Q) And Child Health Assessment Questionnaire (CHAQ) Answered By Parents And Children at Assessment

Questionnaires On QoL	JIA Children, n = 40*	Uveitis, n = 7*	No Uveitis, n = 33*	P-Value
EYE-Q (04)ª Median outcome scores (range)**	0 (00.56)	0 (0	0 (0	0.78
CHAQ (03)ª disability index Median outcome scores (range)**	0 (0	0 (0	0 (0	0.97
CHAQ (03)ª self report 8 yrs	0 (00.52) n = 15	0 (0) n = 2	0 (00.52) n = 13	0.44
CHAQ (03)ª parent report 8yrs	0.03 (01.32) n = 25	0.14 (00.38) n = 5	0.017 (01.32) n = 20	0.86
CHAQ VAS Median (range)
Pain (0^a	0 (0	0 (0	0 (0	0.58
Pain (0^a self report  8 yrs	0 (04.2) n = 15	0 (0) n = 2	0 (04.2) n = 13	0.44
Pain (0^a parent report 8yrs	0.2 (04.7) n = 25	0 (03.5) n = 5	0.3 (04.7) n = 20	0.83
Overall well-being (0^a	0.25 (0	0 (0	0.3 (0	0.84
Overall well-being (0^a self report  8 yrs	0 (02.5) n = 15	0 (0) n = 2	0 (02.5) n = 13	0.45
Overall well-being (0^a parent report 8yrs	0.9 (06.4) n = 25	(05.4) n = 5	0.75 (06.4) n = 20	1.00

Notes: *Where numbers differ from the total number of children in the group, they are given separately for each category. **Median (range) is calculated on the mean of the scores for CHAQ disability index – parent and self-reports. ªHigher scores indicate worse quality of life. Both pain and overall well-being were measured by a visual analog scale based on a Likert scale of 0-10 cm, where higher score indicates more pain/worse well-being. CHAQ disability index scores range from 0 to 3, at which 0 means without any difficulty and 3 means unable to do. We have excluded alternative 4 (not applicable) in our conclusion. EYE-Q scores range from 0 to 5, at which 0 means no difficulty and 4 means unable to do. We have excluded alternative 5 (not applicable) in our conclusion. Higher scores for both CHAQ and EYE-Q indicate worse quality of life.

Abbreviations: CHAQ, Childhood Health Assessment Questionnaire; EYE-Q, Effects of Youngsters’ Eyesight on Quality of Life Questionnaire; JIA, juvenile idiopathic arthritis; n, number of children; QoL, quality of life; VAS, visual analogue scale.

Figure 1 Number of children with juvenile idiopathic arthritis (JIA) needing special aids or devices documented by Child Health Assessment Questionnaire (CHAQ) (A) and number of children with JIA needing help from another person because of illness (B).

Table 5 Comparison Of Effects Of Youngsters’ Eyesight On Quality Of Life Questionnaire (EYE-Q) And Child Health Assessment Questionnaire (CHAQ) In Children With Juvenile Idiopathic Arthritis Having Visual Acuity ≤ or >0.7 Decimal (0.2 Logarithm Of The Minimum Angle Of Resolution)

Questionnaires On VR And HR QoL	JIA Children, n = 40*	VA Best Eye ≤0.7 Decimal (0.2 LogMAR), n = 5	VA Best Eye >0.7 Decimal (0.2 LogMAR), n = 35*	P–Value
EYE-Q (04)^a Median outcome scores (range)**	0.0 (0.0	0.0 (0.0 n = 5	0 (0.0 = 35	0.013
CHAQ (03)^a disability index Median outcome scores (range)**	0.0 (0.01.32) n = 40	0.143 (0.0 1.321) n = 5	0.0 (0.01.318) n = 35	0.066
CHAQ (03)^a self report 8 yrs	0.0 (0.00.517) n = 15		0.0 (0.00.517) n = 15
CHAQ (03)^a parent report 8yrs	0.033 (0.01.321) n = 25	0.143 (0.01.321) n = 5	0.0 (0.01.318) n = 20	0.21
CHAQ VAS Median (range)
Pain (0^a	0.0 (0.04.700) n = 40	0.40 (0.02.200) n = 5	0.0 (0.04.700) n = 35	0.63
Pain (0^a self report 8 yrs	0.0 (0.04.200) n = 15		0.0 (0.04.200) n = 15
Pain (0^a parent report 8 yrs	0.20 (0.04.700) n = 25	0.40 (0.02.200) n = 5	0.10 (0.04.700) n = 20	1.00
Overall well-being (0^a	0.0 (0.02.500) n = 15	1.70 (0.03.80) n = 5	0.0 (0.06.400) n = 35	0.12
Overall well-being (0^a self report 8 yrs	0.0 (0.02.500) n = 15		0.0 (0.02.500) n = 15
Overall well-being (0^a parent report 8 yrs	0.90 (0.06.40) n = 25	1.70 (0.03.80) n = 5	0.75 (0.0 6.40) n = 20	0.39

Notes: *Where numbers differ from the total number of children in the group, they are given separately for each category. **Median (range) is calculated on the mean of the scores for CHAQ disability index – parent and self-reports. ªHigher scores indicate worse quality of life.

Abbreviations: CHAQ, Childhood Health Assessment Questionnaire; EYE-Q, Effects of Youngsters’ Eyesight on Quality of Life Questionnaire; HR, health-related; JIA, juvenile idiopathic arthritis; LogMAR, logarithm of the minimum angle of resolution; n, number of children; OoL, quality of life; VA, visual acuity; VAS, visual analogue scale; VR, visual-related.

Figure 2 Medical treatment in 40 children without (A) and with (B) juvenile idiopathic arthritis (JIA)-associated uveitis at the time of assessment.