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Pediatric Pars Planitis: A Review
Sana Khochtali1, Pinar Ozdal2, Abdulrahman F AlBloushi3
1Department of Ophthalmology, Faculty of Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia.
Insights
Pediatric pars planitis, an idiopathic intermediate uveitis, can cause vision loss, most commonly from cystoid macular edema. Early diagnosis and treatment are essential for preserving sight in children.
Area of Science:
- Ophthalmology
- Pediatric Uveitis
Background:
- Pars planitis is an idiopathic intermediate uveitis characterized by vitritis and snowball/snowbank formations.
- It is considered a T-cell mediated condition with genetic factors, accounting for a significant portion of pediatric uveitis cases.
Purpose of the Study:
- To offer a comprehensive overview of pediatric pars planitis.
Main Methods:
- A narrative literature review was conducted.
Main Results:
- Pediatric pars planitis presents insidiously, often bilaterally, with floaters and blurred vision.
- While generally benign, complications like cystoid macular edema can lead to visual morbidity.
- Treatment involves a stepladder approach, including corticosteroids, immunosuppressants, anti-TNF-alpha therapy, and surgical interventions.
Conclusions:
- Prompt diagnosis and appropriate management of pediatric pars planitis and its complications are vital for optimal visual outcomes.
Purpose:
To provide an overview of pediatric pars planitis.
Methods:
Narrative literature review.
Results:
Pars planitis refers to the idiopathic subset of intermediate uveitis in which there is vitritis along with snowball or snowbank formation occurring in the absence of an associated infection or systemic disease. It is thought to be a T-cell mediated disease with a genetic predisposition. Pars planitis accounts for 5-26.7% of pediatric uveitis cases. Presentation is commonly bilateral but asymmetric, often with insidious onset of floaters and blurred vision. Although pars planitis is known to be a benign form of uveitis in most cases, severe complications secondary to chronic inflammation may arise, with cystoid macular edema being the most common cause of visual morbidity. Mild vitritis in the absence of symptoms, vision loss, or macular edema may be observed. Patients with severe vitritis and/or associated vision-threatening complications require prompt aggressive treatment. A stepladder approach including corticosteroids, immunosuppressive agents, anti‑tumor necrosis factor‑alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis.
Conclusion:
Timely diagnosis and adequate treatment of pediatric pars planitis and associated complications are crucial in order to improve visual outcomes.
