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Juan Carlos Serna-Ojeda, Miguel Pedroza-Seres; Treatment with immunosuppressive therapy in patients with pars planitis: experience of a reference center in Mexico. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5296.
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To evaluate the clinical course of the patients with pars planitis that received immunosuppressive drugs.
We retrospectively analyzed the data of 10 years from 374 patients with pars planitis in a large reference center in Mexico City and included 49 patients (92 eyes)
Median age at presentation was 8 years. 35 patients (71.4%) were male and 43 patients (87.7%) had bilateral disease. The median of the visual acuity at presentation was 20/60 (range 20/20 - light perception). The main complaint was low visual acuity in 37 patients (75.5%). The most common ocular manifestation was vitritis in all the patients and the main ocular complication was cataract in 52.1%. Diverse immunosuppressive medications were used, mainly methotrexate (69.4%) and azathioprine (63.3%) with 18 patients requiring more than one drug. The main indications for starting immunosuppressive therapy were lack of response to initial treatment and advance disease at presentation. The results showed good response with steroid reduction (69.3% of patients), visual acuity improvement (51% of patients) and inflammatory disease reduction (59.1% of patients). In 25 patients (51%) steroids were started previous to immunosuppressors and in 24 (49%) at the same time without significant difference in clinical improvement (p=0.210) or visual outcome (p=0.498). Thirteen patients (26.5%) presented mild adverse effects. Median follow up was 4 years. The median of the final visual acuity was 20/40 (range 20/20 - no light perception).
Immunosuppressive therapy allows an adequate control of inflammatory disease in pars planitis, with clinical and visual improvement and steroid dose reduction.
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