Disease Course Comparison of Pars Planitis in Children Versus Adults

Abstract

Purpose : There is controversy regarding the correlation between the disease course of pars planitis and age. Some studies report worse disease course and visual outcomes in children, whereas other studies show no relationship between prognosis and age. This is a retrospective analysis of the disease course, visual outcomes, and secondary complications of pars planitis in children and adults.

Methods : This is a retrospective multi-provider, single-site study which identified 738 charts of patients with intermediate uveitis. Exclusion criteria include patients with non-idiopathic intermediate uveitis, a follow-up period of <1 year, or an unknown age of diagnosis. After exclusion, 149 patients remained. Yearly visual acuities while in periods of remission, frequency of flares, and development of secondary complications (cataracts, glaucoma, central macular edema, and epiretinal membrane) were collected.

Results : Of the 149 patients with pars planitis, 50 patients (97 eyes) were children (age <18) and 96 (191 eyes) were adults (age ≥18). The mean follow-up duration was 3.4 ± 1.6 years for adults and 3.0 ± 1.8 years for children. The mean best corrected visual acuity (MBCVA) during periods of remission was collected yearly for up to 5 years. The MBCVA at the time of diagnosis was 0.28 logMAR (range -0.12 – 4.7 logMAR) for children, and 0.20 (range -0.12 – 3.7 logMAR) for adults, p = 0.72. The MBCVA at the last follow-up was 0.22 (range -0.12 – 4.7 logMAR) for children, and 0.16 (range -0.12 – 4.7 logMAR) for adults, p = 0.48. The average number of flare relapses within the first 5 years of follow-up was 0.7 (range 0-7 flares) in children and 0.6 (range 0–5 flares) in adults. Table 1 shows the frequency of secondary complications in children and adults.

Conclusions : The data in this study shows no significant difference in visual outcomes or flare frequency by age. In both age groups, the most common secondary complication within the first 5 years is cataract development. However, the development of cystic macular edema, cataract, and epiretinal membrane is significantly higher in adults compared to children.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.