Presumed Trematode-Induced Ciliary Body Granuloma; Clinical Patterns and Management

To describe clinical characteristics, patterns, and surgical outcomes in the management of presumed trematode-induced granulomatous intermediate uveitis (PTIGIU).

Retrospective single-center study in which patients exposed to fresh water canal exposure with PTIGIU were enrolled. Surgery was done after failure of medical treatment in the form of lensectomy and pars plana vitrectomy (PPV). Post-operative functional and anatomical outcomes were assessed.

58 eyes of 56 patients were included with mean age of 12.6 ± 3.07 years, 89.3% males. Ciliary body (CB) granulomas were most commonly present inferiorly (41%) and either extend anteriorly to the lens or circumferential along the CB or posteriorly to the retina and were associated with retinal pathologies in 86.2%; the most common of which was tractional retinal detachment (TRD) (60%). According to retinal pathology, eyes were grouped; Group A: 43 eyes, with early disease, having no or localized peripheral retinal detachment (RD) and B: 15 eyes, with advanced cicatricial disease. Inflammation was well controlled 6 months post-surgery in both groups; however, Group A showed better functional (p = 0.003) and anatomical outcomes (p = 0.01). Lens morphology was negatively correlated with retinal pathology (p = 0.036).

PTIGIU is a potentially blinding disease, with earlier surgical intervention showing better anatomical and functional outcomes.