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Implications of pars planitis-associated cystoid macular edema on visual outcome and management in children
Ana Navarrete1, Adi Koriat1, Radgonde Amer2
1Department of Ophthalmology, Hadassah Medical Center, POB 12000, 91120, Jerusalem, Israel.
Insights
Cystoid macular edema (CME) in pediatric pars planitis is linked to more eye complications and less remission. Early diagnosis and treatment are crucial for better visual outcomes in children with pars planitis.
Area of Science:
- Ophthalmology
- Pediatric uveitis
- Macular edema
Background:
- Pars planitis is a common cause of pediatric uveitis.
- Cystoid macular edema (CME) is a frequent complication impacting vision in these patients.
Purpose of the Study:
- To investigate the impact of CME associated with pars planitis on visual outcomes.
- To evaluate treatment strategies for pediatric pars planitis with CME.
Main Methods:
- Retrospective review of medical records from a single academic center.
- Analysis of data from 33 children (58 eyes) diagnosed with pars planitis.
Main Results:
- CME developed in 31% of eyes, often at presentation or later.
- Eyes with CME showed more anterior/posterior segment complications and papillitis.
- CME was associated with increased systemic therapy use and lower remission rates (13% vs 50%).
- Visual acuity improvement was significantly better in eyes with CME (0.41 LogMAR) compared to those without (0.14 LogMAR) by 36 months.
Conclusions:
- Pars planitis-associated CME leads to increased ocular complications.
- More frequent use of immunomodulatory therapy is required for CME.
- CME is linked to a reduced rate of remission in pediatric pars planitis.
Purpose:
Pars planitis is a commonly observed type of pediatric uveitis. The aim of this study was to evaluate the implications of pars planitis-associated cystoid macular edema (CME) on visual outcome and treatment modalities.
Methods:
A retrospective review of medical records in a single center with academic practice.
Results:
Included were 33 children (mean age 8 years, 58 eyes). Eighteen eyes developed CME (31%): in 67% of them, CME was diagnosed at presentation and in 33%, it developed at a mean of 57 months after presentation. Anterior and posterior segment complications were more prevalent in eyes with CME. Papillitis was significantly associated with the development of CME (OR 12.4, 95% CI 2.3 to 65.6, p = 0.003). Patients with CME were 1.7 times more likely to be treated with systemic therapy. By the last follow-up, 50% of patients who never developed CME were without systemic therapy compared with 13% of patients who developed CME (p = 0.034). LogMAR visual acuity improvement between presentation and month 36 was 0.41 for eyes with CME compared with 0.14 for eyes that never developed CME (p = 0.009).
Conclusion:
Pars planitis-associated CME entailed higher prevalence of ocular complications, more frequent use of immunomodulatory therapy, and a lower rate of remission.
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