Juvenile idiopathic arthritis associated uveitis (JIA-U) is the most common extra-articular manifestation of juvenile idiopathic arthritis (JIA) and carries considerable risk to vision. The aim of this systematic review was to synthesise evidence of environmental risk factors for JIA-U and identify risk factors which may be modifiable or used to stratify JIA patients. This systematic review was carried out in accordance with PRISMA guidelines. Four online databases - Cumulative Index of Nursing and Allied Health Literature, Web of Science, MEDLINE and Embase - were searched from database inception to 12th August 2020. Identified studies were screened by two independent reviewers against pre-defined inclusion and exclusion criteria. Data was extracted from all primary studies meeting inclusion criteria and independently checked. We identified three studies from 895 unique records which met the inclusion criteria, each examining a different environmental risk factor. This systematic review includes 973, predominantly female, participants with JIA across these three studies. The use of allergy medication or documentation of “allergy”/“allergic” in the medical records was associated with an increased risk of JIA-U in all models presented. Vitamin D sufficiency was associated with reduced risk of JIA-U. There was insufficient evidence to support an association between seasonality and JIA-U. This review identifies a potential role for allergy and vitamin D in JIA-U. It also illustrates the paucity of data regarding environmental risk factors for JIA-U and highlights the need for further research to both identify additional risk factors and replicate existing findings.

中文翻译：

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“与幼年特发性关节炎相关的葡萄膜炎相关的环境危险因素：文献的系统评价”

幼年特发性关节炎相关葡萄膜炎 (JIA-U) 是幼年特发性关节炎 (JIA) 最常见的关节外表现，对视力有相当大的风险。本系统评价的目的是综合 JIA-U 环境风险因素的证据，并确定可修改或用于对 JIA 患者进行分层的风险因素。该系统评价是根据 PRISMA 指南进行的。从数据库开始到 2020 年 8 月 12 日，搜索了四个在线数据库——护理和联合健康文献累积索引、Web of Science、MEDLINE 和 Embase。确定的研究由两名独立评审员根据预先定义的纳入和排除标准进行筛选。从所有符合纳入标准的主要研究中提取数据并独立检查。我们从 895 条符合纳入标准的独特记录中确定了三项研究，每项研究都检查了不同的环境风险因素。该系统评价包括这三项研究中的 973 名 JIA 参与者，主要是女性。在所有模型中，使用抗过敏药物或病历中记录“过敏”/“过敏”与 JIA-U 风险增加有关。维生素 D 充足与 JIA-U 风险降低有关。没有足够的证据支持季节性与 JIA-U 之间的关联。本综述确定了过敏和维生素 D 在 JIA-U 中的潜在作用。它还说明了有关 JIA-U 环境风险因素的数据不足，并强调需要进一步研究以识别其他风险因素并复制现有研究结果。