Purpose:
To determine the macular manifestations in pars planitis by means of spectral domain optical coherente tomography (SD-OCT), and to analyze the risk of developing macular edema (ME) unresponsive to treatment associated to epiretinal membrane formation (ERM).
Methods:
Longitudinal, retrospective, descriptive and comparative case-control study. Inclusion criteria were patients with prior diagnosis of pars planitis with complete fundoscopic examination, fluoresceine angiography (FA) and SD-OCT. A description of the macular alterations detected by SD-OCT was done. Patients with ERM and angiographic macular edema were compared to determine the influence of the membranes on the presence of edema.
Results:
90 eyes of 53 patients were studied. OCT findings were the following. ERM was present in 28 eyes (31.1%); vitreo-macular tractional syndrome in 10 eyes (11.1%); CME in 5 eyes (5.5%); retinal detachment in 1 eye (1.1%); retinal fibrosis in 3 eyes (3.3%).Of the 28 eyes that had ERM, 11 had persistent angiographic ME, unresponsive to treatment; 62 eyes did not present ERM, 10 developed persistent ME.A relative risk factor of 2.4 to develop ME with a prior ERM was determined.
Conclusions:
The most common macular complication in PP was ERM. Although clear media facilitates examination and an adequate OCT signal, the advantage of OCT is the highly reflective appearance of an ERM. Although it is the most common complication in PP it might be underdiagnosed clinically.Our result suggest that there is an association between ERM and persistent ME. A prospective and randomized trial could be helpful to determine if a surgical approach in these patients has a better outcome in terms of the presence of ME and visual acuity.
Keywords: inflammation • macula/fovea • uveitis-clinical/animal model