<p><strong>BACKGROUND: </strong>Juvenile spondyloarthritis (JSpA) represents a group of inflammatory arthritides with several distinctive features (enthesitis, involvement of spine and sacroiliac joint, HLA-B27 association and development of uveitis). There are limited data on the course of uveitis in children with JSpA. This study aims to estimate the prevalence of uveitis and to look at the presence of HLA-B27 in relation to uveitis occurrence and ocular symptoms in a cohort of JSpA patients.</p>

<p><strong>FINDINGS: </strong>This is a cross sectional/retrospective study involving patients with JSpA followed in a tertiary referral hospital. Two hundred twenty-three patients were enrolled in the study. The prevalent diagnosis was enthesitis-related arthritis (ERA) (62%) followed by juvenile psoriatic arthritis (PsA), undifferentiated arthritis (UA), and the arthropathies associated with inflammatory bowel disease (IBD-A) (18, 14, 6%, respectively). Uveitis was reported in twenty-four patients (11%) of the JSpA cohort (JSpA-U). ERA patients had the highest uveitis prevalence (ERA-U) (13%) with similar prevalences in UA, PsA and in IBD-A (7% each). The prevalence of HLA-B27 positivity was similar amongst the entire JSpA-U cohort (N&nbsp;= 22, 45%) and those with ERA-U (N&nbsp;= 8, 44%). The overall prevalence of symptomatic uveitis was 79%. Neither the likelihood of uveitis, nor of symptomatic uveitis, varied by HLA-B27 status either in the entire cohort nor in those with ERA.</p>

<p><strong>CONCLUSIONS: </strong>About one-tenth of patients developed uveitis, the majority of which was symptomatic. Fewer than half of the patients with uveitis were HLA-B27 positive. HLA-B27 status was not statistically associated with either the development of uveitis or symptomaticity of uveitis.</p>

<p><strong>PURPOSE: </strong>To describe the prevalence of symptoms with noninfectious uveitis (NIU) in a pediatric cohort and to assess the association between the presence of symptoms with first episode of uveitis (first-U) compared to symptoms at uveitis recurrence.</p>

<p><strong>METHODS: </strong>The medical records of patients with NIU treated at a tertiary referral hospital from March 2008 to November 2107 were reviewed retrospectively. Symptomaticity (eye pain, eye redness, photosensitivity) was captured at initial uveitis activation and subsequent episodes. Univariate logistic regression modeling was used to identify clinical features associated with symptomatic first-U. Ordinal regression identified patient characteristics associated with symptomatic recurrence.</p>

<p><strong>RESULTS: </strong>A total of 118 cases were reviewed; of these, 92 were followed for at least 6 months and had at least 1 reactivation. Juvenile idiopathic arthritis-related uveitis (JIAU) was the most common diagnosis (67/118 [57%]), followed by idiopathic uveitis (33%). In the majority, uveitis was restricted to the anterior chamber (82%). Of the 118 cases, 58 patients (49%) had symptomatic first-U, 34% JIA versus 69% non-JIA. Non-JIAU, age ≥7 years, and negative antinuclear antibody (ANA) test were significantly associated with symptomatic first-U; spondyloarthritis was not. With recurrence, half had symptoms: 41% JIA versus 66% non-JIA. Of those who had symptomatic first-U, 35% were asymptomatic at recurrence. Those with JIA had 50% or less odds of symptomaticity at reactivation. Complications did not vary based on having had symptoms at first-U.</p>

<p><strong>CONCLUSIONS: </strong>Non-JIA diagnosis, older age, and ANA-negativity were associated with symptomatic first-U in our study cohort, but no patient characteristics were significantly associated with symptomatic recurrence. Clinical patterns may change during disease course, with uveitis switching from symptomatic to asymptomatic, which has implications for uveitis monitoring recommendations.</p>