Principal Investigator/Program Director (Last, first, middle): Angeles-Han, Sheila, TProject SummaryJuvenile idiopathic arthritis-associated uveitis (JIA-U) is an inflammatory eye disease that affects 20% ofchildren with JIA and can lead to cataracts, glaucoma, vision loss and blindness. Current screening guidelinesare designed to identify children at risk for eye disease in JIA. However, pediatric rheumatologists' andophthalmologists' ability to provide comprehensive screening for uveitis is limited because the guidelines havenot been updated to include all juvenile arthritis subtypes and other known risk factors for vision-limitingcomplications of JIA. Screening in JIA and other related autoimmune diseases of childhood is crucial becauseearly uveitis detection can prevent visual complications and influence therapeutic management. Likewise,institution of early aggressive therapy when needed may avert serious visual complications. To improve healthoutcomes and quality of life of children with JIA-U, we need a better understanding of risk factors for uveitis,long-term visual outcomes, and the effects of visual and physical disability on children's lives. Early andaccurate identification of JIA-U through the identification of risk factors for susceptibility and severity of uveitis,standardization of outcome measures, and elucidation of the significance of HLA risk alleles would improve theevaluation of the impact of JIA-U and the understanding of disease etiology, pathogenesis and outcome.Likewise, an improved risk stratification scheme could reduce unnecessary ophthalmology visits and help usidentify children at greater risk for severe eye disease and complications.The objectives of this study are to 1) Identify differences in the clinical characteristics and course of JIA-U inpatients of European and African descent in children with JIA to identify clinical and genetic risk markers foruveitis, 2) Examine the risk factors identified over a 4-year prospective study of a cohort of children diagnosedwith early JIA to determine which factors are associated with eventual development of uveitis, and provide dataon their longitudinal profile, 3) Determine the impact of having both arthritis and uveitis on physical and visualdisability, vision-specific QOL, and overall QOL using subjective and objective measures. Using acomprehensive biologic, genetic and psychosocial approach, we hope to develop more widely applicable riskstratification schemes based on JIA subtype, and to identify new risk factors that will identify the populations ofchildren at greatest risk for severe disability and blindness so that interventions can be developed to improvetheir overall outcome.The candidate is a pediatric rheumatologist and an assistant professor of pediatrics at Emory University. Shehas obtained a Masters of Science in Clinical Investigation. She is devoted to a career in clinical outcomesresearch in children with autoimmune eye diseases. She has assembled an outstanding mentoring team withexperience in pediatric rheumatology, pediatric ophthalmology, pediatric epidemiology, outcomes research andmeasurement, which are relevant to her objectives. This mentored award will help her become a successfulindependent clinician scientist.Project Description Page 7
; first; middle): Angeles-Han; Sheila; TProject NarrativeJuvenile idiopathic arthritis-associated uveitis (JIA-U) is an inflammatory eye disease that affects 20% ofchildren with JIA. This research will validate known risk factors and identify new risk markers of JIA-U;identifying populations of children at greatest risk for severe disability and blindness. It is anticipated that earlydetection of JIA-U; regular monitoring for eye disease and complications; and institution of appropriate therapycan significantly improve our children's quality of life and long-term outcomes.Public Health Relevance Statement Page 8
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