Abstract
Purpose: :
To describe pars planitis treatment outcomes in young children.
Methods: :
The medical records of all patients with pars planitis from 1998 through 2011 were retrospectively reviewed. Patients who were selected were less than or equal to 16 years of age and had vitreous snowballs or snow banking secondary to pars planitis. Patients with anterior uveitis, posterior uveitis, and panuveitis were excluded. Twelve patients (15 eyes) underwent a range of medical and surgical interventions and the pre-treatment and post-treatment visual acuities and intraocular pressures were compared.
Results: :
The mean age at the initial visit was 10 years old with an average follow up of 4 years (range, 7 months to 10 years). The average presenting visual acuity was 20/40. The presenting visual acuity ranged from 20/20 to 20/150 in 12 patients and 15 eyes. Fifteen eyes underwent posterior subtenons triamcinolone injection, seven eyes received cryotherapy, three patients were controlled with methotrexate, two patients were controlled with infliximab, and two patients were controlled with cellcept. Remission was obtained in three patients after cessation of immunomodulatory therapy and four patients remained disease free while on immunomodulatory therapy. Average final visual acuity was 20/24 (range: 20/20 - 20/100) with improvement in 11 eyes (73%) and no change of visual acuity in three eyes (20%). One eye had a change in visual acuity post-treatment (7%) from 20/20 to 20/25 secondary to formation of a cataract.
Conclusions: :
Pars planitis in the pediatric population responds well to a combination of posterior subtenons triamcinolone injection, cryotherapy, and immunomodulatory therapy with a low likelihood of breakthrough disease. Complications of treatment encountered include: cataract, elevated intraocular pressure, and ptosis.
Keywords: uveitis-clinical/animal model