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sho ishikawa, sayuri hujii, kei takayama, masaru takeuchi; Surgical Outcome of Vitrectomy for Ocular Complications Resistant for Medical treatment in Patients with Endogenous Uveitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3206.
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The principle treatment of endogenous uveitis is to reduce ocular inflammation by medical techniques. However, in the case that chronic and recurrent inflammation gives rise to irreversible complications that are refractory to medical treatment, surgical treatment is performed to maintain or improve the patient's visual function. In this study, we indicate outcome of vitreous surgery performed for ocular complications in patients with endogenous uveitis.
Vitreous surgery was performed for 39 patients (48 eyes) with different type of endogenous uveitis from April 2007 to August 2011. The average age was 53.5 +/- 17.9 years (ranging from 21 to 78 years), and the diagnosis of uveitis was as follows: sarcoidosis, 12 eyes; Behcet’s disease (BD), 9 eyes; retinal vasculitis, 7 eyes; juvenile idiopathic arthritis-associated uveitis and Fuchs heterochromic iridocyclitis, 1 eye respectively; and idiopathic uveitis, 18 eyes. The complications treated by vitreous surgery were vitreous opacity, 25 cases; epiretinal membrane, 17 eyes; macular edema, 8 eyes; vitreous hemorrhage, 7 eyes; macular hole, 2 eyes; and proliferative vitreoretinopathy (PVR), 5 eyes (including overlaps). All patients were followed for more than three months after vitrectomy, and visual acuity and ocular inflammation scores in the remission phase before vitrectomy and at the latest visit after vitrectomy were used for evaluation. JMP software version 5 was used for statistical analysis.
Visual acuity was improved in 37 out of 48 eyes after operation, and statistical analysis using visual acuity converted to Log MAR showed significant improvement after vitrectomy. In addition, ocular inflammatory scores were significantly decreased after vitrectomy not only in the posterior segment but also in the anterior segment. In BD patients, the number of ocular attacks per year also decreased significantly after vitrectomy. However, visual acuity deteriorated or remained unchanged after vitrectomy in 11 out of 48 eyes, that was especially more in uveitis patients with poor pre-operative visual acuity.
Vitrectomy was generally effective for medically refractory ocular complications of endogenous uveitis, with favorable outcomes of improved visual acuity and decreased uveitis activity.
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