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Treatment with immunosuppressive therapy in patients with pars planitis: experience of a reference centre in Mexico
Juan Carlos Serna-Ojeda1, Miguel Pedroza-Seres1
1Department of Uveitis and Ocular Immunology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico.
Aim:
To evaluate the clinical course of the patients with pars planitis that received immunosuppressive drugs.
Methods:
We retrospectively analysed the data of 10 years from 374 patients with pars planitis in a large reference centre in Mexico City and included 49 patients (92 eyes).
Results:
Median age at presentation was 8 years. 35 patients (71.4%) were male and 43 patients (87.7%) had bilateral disease. Diverse immunosuppressive medications were used, mainly methotrexate (69.4%) and azathioprine (63.3%) with 18 patients requiring more than one drug. The main indications for starting immunosuppressive therapy were lack of response to initial treatment and advance disease at presentation. The results showed good response with steroid reduction (69.3% of patients), visual acuity improvement (51% of patients) and inflammatory disease reduction (59.1% of patients). In 25 patients (51%), steroids were started previous to immunosuppressors and in 24 (49%) at the same time without significant difference in clinical improvement (p=0.210) or visual outcome (p=0.498). Thirteen patients (26.5%) presented mild adverse effects. The median of the final visual acuity was 20/40. The median follow-up time was 44 months (range 13-115 months).
Conclusions:
Immunosuppressive therapy allows an adequate control of inflammatory disease in pars planitis, with clinical and visual improvement and steroid dose reduction.