Better monitoring of intraocular inflammation by laser flare photometry and diversified therapeutical approach could mean improved outcome for JIA

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Slit lamp biomicroscopy is widely used to evaluate the importance of anterior segment flare and cells in children with anterior uveitis. However, different studies have clearly shown that other tools such as laser flare photometry may improve the monitoring during the follow-up. Laser flare photometry showed for the first time that active ocular inflammation may be associated with a significant level of flare even in the absence of detectable cells. This is a major finding to start a therapeutic approach or change it for a more aggressive strategy and monitor the decrease of flare. Moreover, the level of flare decrease under therapy may predict further serious complications such as secondary glaucoma or cataract. Based on our modern monitoring tools, therapeutic strategies have been progressively modified, allowing a better control of chronic uveitis. Efficacy and tolerance of anti-TNF alpha agents will be discussed and alternatives in severe and resistant cases will be discussed.

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