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Benjamin Chaon, James Folk, Elliott Sohn; Inflammatory activity and visual outcomes in patients treated with cryotherapy for pars planitis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5397.
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Most current treatments for visually disabling pars planitis have the potential for systemic and local toxicity. This study aims to determine the clinical outcomes of cryotherapy in a cohort of patients with vision loss from pars planitis.
A retrospective chart review of patients with pars planitis treated at the University of Iowa from 1973 to 2011 was conducted. Patients who underwent cryotherapy met inclusion criteria if they demonstrated evidence of intraocular inflammation with snowbanking and had a negative serologic workup for other causes of inflammation. LogMAR visual acuity, inflammatory activity, structural complications, and use of topical and/or systemic steroid and immunosuppressive agents were compared in the pre-cryotherapy period and at 9-24 months following cryotherapy.
38 cryotherapy-treated eyes of 27 patients with pars planitis were included in this study. The mean Snellen visual acuity of the eyes prior to cryotherapy was 20/70 (range 20/15 to “hand motion”). The mean Snellen visual acuity at an average of 18 months following cryotherapy was 20/37 (range 20/15 to 20/200). Visual acuity improved or remained unchanged in 76% of cryotherapy-treated eyes. The average change in logMAR acuity from baseline was -0.2637 log units, corresponding to a modest improvement in vision (p=0.0084). The average time from presentation to cryotherapy was 28 months. The mean number of cryotherapy treatments was 1.34 with 21% of eyes requiring more than 1 treatment. Cystoid macular edema was present in 56% of eyes at time of cryotherapy and 17% of eyes at follow-up after cryotherapy.
Visual acuity improved or remained stable in the majority of patients treated with cryotherapy. Cryotherapy was also associated with a resolution of cystoid macular edema, suggesting a role for cryotherapy in treating structural complications and vision loss caused by pars planitis.
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