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Abstract
Purpose
To investigate the clinical characteristics and treatment of intermediate uveitis under new diagnostic standards. Methods: Medical records of patients diagnosed with pars planitis or intermediate uveitis were followed for more than 6 months, and retrospectively reviewed.
Results
A total of 90 patients and 117 eyes were enrolled in the study. The mean age was 40.1 years, and the mean follow-up period was 43.0 months. Thirty percent of cases were bilateral. The most common initial symptom was decreased visual acuity. Snowbank was detected in 39.3%, snowballs in 15.4%, vitritis in 96.6%, and vasculitis in 56.4%. Common complications includedcystoid macular edema (57.3%), cataracts (43.6%), and epiretinal membrane (36.8%). Therapies included topical steroids (82.9% of cases), posterior sub-Tenon steroid injection (45.3% of cases), systemic steroid administration (67.8% of cases), and immunosuppressants (28.7% of cases). Vitrectomy was performed in 11.1% of patients due to complications such as epiretinal membrane and traction retinal detachment. The mean initial and final visual acuities were 0.67 and 0.74, respectively.
References
1. The standardization of Uveitis Nomenclature (SUN) working group Standardization of Uveitis Nomenclature for Reporting Clinical Data. Results of the First International Workshop. Am J Ophthalmol. 2005; 140:509–16.
2. Vitale AT, Zierhut M, Foster CS. Diagnosis and treatment of uveitis. Philadelphia: WB Saunders Company;2001. p. 844–57.
3. Bonfioli AA, Damico FM, Curi AL, Orefice F. Intermediate uveitis. Semin Ophthalmol. 2005; 20:147–54.
4. Park IW, Chung H. Clinical analysis of peripheral uveitis. J Korean Ophthalmol Soc. 1989; 30:535–41.
5. Park JW, Cho HJ, Seo MS. Clinical analysis of pars planitis with promeinent snowbank. J Korean Ophthalmol Soc. 2002; 43:509–15.
6. Park WC, Chung H. Clinical analysis of intermediate uveitis. J Korean Ophthalmol Soc. 2003; 44:344–50.
7. Smith RE, Godfrey WA, Kimura SJ. Chronic cyclitis. I. Course and visual prognosis. Trans Am Acad Ophthalmol Otolaryngol. 1973; 77:760–8.
8. Palimeris G, Marcomichelakis N, Konstantinidou V, Trak-aniari AN. Intermediate uveitis: What is the natural course of the disease and its relationship with other systemic disease? Eur J Ophthalmol. 1994; 4:223–7.
9. Lai WW, Pulido JS. Intermediate uveitis. Ophthalmol Clin North Am. 2002; 15:309–17.
10. Donaldson MJ, Pulido JS, Herman DC. . Pars planitis: A 20-Year Study of Incidence, Clinical Features, and Outcomes. Am J Ophthalmol. 2007; 144:812–7.
11. Lauer AK, Smith JR, Robertson JE, Rosenbaum JT. Vitreous hemorrhage is a common complication of pediatric pars planitis. Ophthalmology. 2002; 109:95–8.
12. Henderly DE, Genstler AJ, Rao NA, Smith RE. Pars planitis. Trans Ophthalmol Soc U K. 1986; 105:227–32.
13. Raja SC, Jabs DA, Dunn JP. . Pars planitis: Clinical features and class II HLA associations. Ophthalmology. 1999; 106:594–9.
14. Malinowski SM, Pulido JS, Folk JC. Long-term visual outcome and complications associated with pars planitis. Ophthalmology. 1993; 100:818–24.
15. Guest S, Funkhouser E, Lightman S. Pars planitis: A com-parison of childhood onset and adult onset disease. Clin Experiment Ophthalmol. 2001; 29:81–4.
16. Imrie FR, Dick AD. Nonsteroidal drugs for the treatment of noninfectious posterior and intermediate uveitis. Curr Opin Ophthalmol. 2007; 18:212–9.
17. Schlagel TF Jr, Weber JC. Treatment of pars planitis, II corticosteroids. Surv Ophthalmol. 1977; 22:120. 125–30.
Table 1.
Distribution of age
| Age | No. of patients (%) |
|---|---|
| < 10 | 3 (3.3) |
| 10~19 | 4 (4.4) |
| 20~29 | 9 (10.0) |
| 30~39 | 26 (28.9) |
| 40~49 | 30 (33.3) |
| 50~59 | 10 (11.1) |
| ≥ 60 | 8 (8.9) |
| Total | 90 (100) |
Table 2.
Follow-up periods
| Period 6M~1Y | Cases (%) 16 (13.7) |
|---|---|
| 1~2Y | 27 (23.1) |
| 2~4Y | 34 (29.1) |
| 4~8Y | 32 (27.4) |
| > 8Y | 8 (6.8) |
| Total | 117 (100) |
Table 3.
Duration of disease at the first visit
| Period | Cases (%) |
|---|---|
| <1M | 36 (30.8) |
| 1~6M | 31 (26.5) |
| 6~12M | 11 (9.4) |
| 1~2Y | 11 (9.4) |
| 2~4Y | 14 (12.0) |
| > 4Y | 14 (12.0) |
| Total | 117 (100) |
Table 4.
Initial symptoms
| Symptom | Cases (%) |
|---|---|
| Decreased visual acuity | 69 (59.0) |
| Floater | 20 (17.1) |
| Injection | 11 (9.4) |
| Discomfort | 7 (6.0) |
| Ocular pain | 4 (3.4) |
| Metamorphopsia | 1 (0.9) |
| No symptom | 11 (9.4) |
Table 5.
Location of snowbank
| Location | Cases (%) |
|---|---|
| Superior | 34 (77.3) |
| Inferior | 10 (22.7) |
| Superior and Inferior | 4 (9.1) |
| Others | 4 (9.1) |
Table 6.
Ocular findings and complications
Table 7.
Treatments
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