Skip to main content
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 8/2020

28.04.2020 | Inflammatory Disorders

Implications of pars planitis-associated cystoid macular edema on visual outcome and management in children

verfasst von: Ana Navarrete, Adi Koriat, Radgonde Amer

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 8/2020

Einloggen, um Zugang zu erhalten

Abstract

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.
Literatur
1.
Zurück zum Zitat Ozdal PC, Berker N, Tugal-Tutkun I (2015) Pars planitis: epidemiology, clinical characteristics, management and visual prognosis. J Ophthalmic Vis Res 10:469–480CrossRef Ozdal PC, Berker N, Tugal-Tutkun I (2015) Pars planitis: epidemiology, clinical characteristics, management and visual prognosis. J Ophthalmic Vis Res 10:469–480CrossRef
2.
Zurück zum Zitat Sancho L, Kramer M, Koriat A et al (2019) Complications in intermediate uveitis: prevalence, time of onset, and effects on vision in short-term and long-term follow-up. Ocul Immunol Inflamm 27:447–455CrossRef Sancho L, Kramer M, Koriat A et al (2019) Complications in intermediate uveitis: prevalence, time of onset, and effects on vision in short-term and long-term follow-up. Ocul Immunol Inflamm 27:447–455CrossRef
3.
Zurück zum Zitat Habot-Wilner Z, Tiosano L, Sanchez JM et al (2018) Demographic and clinical features of pediatric uveitis in Israel. Ocul Immunol Inflamm 17:1–11 Habot-Wilner Z, Tiosano L, Sanchez JM et al (2018) Demographic and clinical features of pediatric uveitis in Israel. Ocul Immunol Inflamm 17:1–11
4.
Zurück zum Zitat de Boer J, Wulffraat N, Rothova A (2003) Visual loss in uveitis of childhood. Br J Ophtalmol 87:879–884CrossRef de Boer J, Wulffraat N, Rothova A (2003) Visual loss in uveitis of childhood. Br J Ophtalmol 87:879–884CrossRef
6.
Zurück zum Zitat de Boer J, Berendschot TT, van der Does P, Rothova A (2006) Long-term follow-up of intermediate uveitis in children. Am J Ophthalmol 141:616–621CrossRef de Boer J, Berendschot TT, van der Does P, Rothova A (2006) Long-term follow-up of intermediate uveitis in children. Am J Ophthalmol 141:616–621CrossRef
7.
Zurück zum Zitat Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature (SUN) Working Group (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140:509–516CrossRef Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature (SUN) Working Group (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140:509–516CrossRef
8.
Zurück zum Zitat Nussenblatt RB, Palestine AG, Chan CC, Roberge F (1985) Standardization of vitreal inflammatory activity in intermediate and posterior uveitis. Ophthalmology 92:467–471CrossRef Nussenblatt RB, Palestine AG, Chan CC, Roberge F (1985) Standardization of vitreal inflammatory activity in intermediate and posterior uveitis. Ophthalmology 92:467–471CrossRef
9.
Zurück zum Zitat Sicotte NL, Voskuhl RR (2001) Onset of multiple sclerosis associated with anti-TNF therapy. Neurology. 57:1885–1888CrossRef Sicotte NL, Voskuhl RR (2001) Onset of multiple sclerosis associated with anti-TNF therapy. Neurology. 57:1885–1888CrossRef
10.
Zurück zum Zitat Paroli MP, Spinucci G, Monte R et al (2011) Intermediate uveitis in a pediatric Italian population. Ocul Immunol Inflamm 19:321–326CrossRef Paroli MP, Spinucci G, Monte R et al (2011) Intermediate uveitis in a pediatric Italian population. Ocul Immunol Inflamm 19:321–326CrossRef
11.
Zurück zum Zitat Jain R, Ferrante P, Reddy GT, Lightman S (2005) Clinical features and visual outcome of intermediate uveitis in children. Clin Exp Ophthalmol 33:22–25CrossRef Jain R, Ferrante P, Reddy GT, Lightman S (2005) Clinical features and visual outcome of intermediate uveitis in children. Clin Exp Ophthalmol 33:22–25CrossRef
12.
Zurück zum Zitat Rosenberg KD, Feuer WJ, Davis JL (2004) Ocular complications of pediatric uveitis. Ophthalmology 111:2299–2306CrossRef Rosenberg KD, Feuer WJ, Davis JL (2004) Ocular complications of pediatric uveitis. Ophthalmology 111:2299–2306CrossRef
13.
Zurück zum Zitat Khairallah M, Attia S, Zaouali S et al (2006) Pattern of childhood-onset uveitis in a referral center in Tunisia, North Africa. Ocul Immunol Inflamm 14:225–231CrossRef Khairallah M, Attia S, Zaouali S et al (2006) Pattern of childhood-onset uveitis in a referral center in Tunisia, North Africa. Ocul Immunol Inflamm 14:225–231CrossRef
14.
Zurück zum Zitat Ganesh SK, Bala A, Biswas J, Ahmed AS, Kempen JH (2016) Pattern of pediatric uveitis seen at a tertiary referral center from India. Ocul Immunol Inflamm 24(4):402–409PubMed Ganesh SK, Bala A, Biswas J, Ahmed AS, Kempen JH (2016) Pattern of pediatric uveitis seen at a tertiary referral center from India. Ocul Immunol Inflamm 24(4):402–409PubMed
15.
Zurück zum Zitat Keino H, Watanabe T, Taki W et al (2017) Clinical features of uveitis in children and adolescents at a tertiary referral centre in Tokyo. Br J Ophthalmol 101:406–410CrossRef Keino H, Watanabe T, Taki W et al (2017) Clinical features of uveitis in children and adolescents at a tertiary referral centre in Tokyo. Br J Ophthalmol 101:406–410CrossRef
16.
Zurück zum Zitat Päivönsalo-Hietanen T, Tuominen J, Saari KM (2000) Uveitis in children: population-based study in Finland. Acta Ophthalmol Scand 78(1):84–88CrossRef Päivönsalo-Hietanen T, Tuominen J, Saari KM (2000) Uveitis in children: population-based study in Finland. Acta Ophthalmol Scand 78(1):84–88CrossRef
17.
Zurück zum Zitat Azar D, Martin F (2004) Paediatric uveitis: a Sydney clinic experience. Clin Exp Ophthalmol 32(5):468–471CrossRef Azar D, Martin F (2004) Paediatric uveitis: a Sydney clinic experience. Clin Exp Ophthalmol 32(5):468–471CrossRef
18.
Zurück zum Zitat Kump LI, Cervantes-Castañeda RA, Androudi SN, Foster CS (2005) Analysis of pediatric uveitis cases at a tertiary referral center. Ophthalmology 112:1287–1292CrossRef Kump LI, Cervantes-Castañeda RA, Androudi SN, Foster CS (2005) Analysis of pediatric uveitis cases at a tertiary referral center. Ophthalmology 112:1287–1292CrossRef
19.
Zurück zum Zitat Kalinina Ayuso V, ten Cate HA, van den Does P et al (2011) Young age as a risk factor for complicated course and visual outcome in intermediate uveitis in children. Br J Ophthalmol 95:646–651CrossRef Kalinina Ayuso V, ten Cate HA, van den Does P et al (2011) Young age as a risk factor for complicated course and visual outcome in intermediate uveitis in children. Br J Ophthalmol 95:646–651CrossRef
20.
Zurück zum Zitat Le Scanff J, Sève P, Renoux C et al (2008) Uveitis associated with multiple sclerosis. Mult Scler 14:415–417CrossRef Le Scanff J, Sève P, Renoux C et al (2008) Uveitis associated with multiple sclerosis. Mult Scler 14:415–417CrossRef
21.
Zurück zum Zitat Smith JR, Rosenbaum JT (2004) Neurological concomitants of uveitis. Br J Ophthalmol 88:1498–1499CrossRef Smith JR, Rosenbaum JT (2004) Neurological concomitants of uveitis. Br J Ophthalmol 88:1498–1499CrossRef
22.
Zurück zum Zitat Zein G, Berta A, Foster CS (2004) Multiple sclerosis-associated uveitis. Ocul Immunol Inflamm 12:137–142CrossRef Zein G, Berta A, Foster CS (2004) Multiple sclerosis-associated uveitis. Ocul Immunol Inflamm 12:137–142CrossRef
23.
Zurück zum Zitat van Oosten B, Barkhof F, Truyen L et al (1996) Increased MRI activity and immune activation in two multiple sclerosis patients treated with the monoclonal anti-tumor necrosis factor antibody cA2. Neurology 47:1531–1534CrossRef van Oosten B, Barkhof F, Truyen L et al (1996) Increased MRI activity and immune activation in two multiple sclerosis patients treated with the monoclonal anti-tumor necrosis factor antibody cA2. Neurology 47:1531–1534CrossRef
24.
Zurück zum Zitat The Lenercept Multiple Sclerosis Study Group and The University of British Columbia MS/MRI Analysis Group (1999) TNF neutralization in MS: results of a randomized, placebo controlled multicenter study. Neurology 53:457–465CrossRef The Lenercept Multiple Sclerosis Study Group and The University of British Columbia MS/MRI Analysis Group (1999) TNF neutralization in MS: results of a randomized, placebo controlled multicenter study. Neurology 53:457–465CrossRef
25.
Zurück zum Zitat Probert L (2015) TNF and its receptors in the CNS: the essential, the desirable and the deleterious effects. Neuroscience 302:2–22CrossRef Probert L (2015) TNF and its receptors in the CNS: the essential, the desirable and the deleterious effects. Neuroscience 302:2–22CrossRef
26.
Zurück zum Zitat Ding T, Ledingham J, Luqmani R et al (2010) BSR and BHPR rheumatoid arthritis guidelines on safety of anti-TNF therapies. Rheumatology 49:2217–2219CrossRef Ding T, Ledingham J, Luqmani R et al (2010) BSR and BHPR rheumatoid arthritis guidelines on safety of anti-TNF therapies. Rheumatology 49:2217–2219CrossRef
27.
Zurück zum Zitat Kemanetzoglou E, Andreadou E (2017) CNS demyelination with TNF-α blockers. Curr Neurol Neurosci Rep 17:36CrossRef Kemanetzoglou E, Andreadou E (2017) CNS demyelination with TNF-α blockers. Curr Neurol Neurosci Rep 17:36CrossRef
Metadaten
Titel
Implications of pars planitis-associated cystoid macular edema on visual outcome and management in children
verfasst von
Ana Navarrete
Adi Koriat
Radgonde Amer
Publikationsdatum
28.04.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 8/2020
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-020-04696-7

Weitere Artikel der Ausgabe 8/2020

Graefe's Archive for Clinical and Experimental Ophthalmology 8/2020 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Die Verwendung von Ophthalmika in der Schwangerschaft und Stillzeit stellt immer eine Off-label-Anwendung dar. Ein Einsatz von Arzneimitteln muss daher besonders sorgfältig auf sein Risiko-Nutzen-Verhältnis bewertet werden. In der vorliegenden …

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Vitrektomie Originalie

Die endogene Endophthalmitis ist eine hämatogen fortgeleitete, bakterielle oder fungale Infektion, die über choroidale oder retinale Gefäße in den Augapfel eingeschwemmt wird [ 1 – 3 ]. Von dort infiltrieren die Keime in die Netzhaut, den …

Bakterielle endogene Endophthalmitis

Vitrektomie Leitthema

Eine endogene Endophthalmitis stellt einen ophthalmologischen Notfall dar, der umgehender Diagnostik und Therapie bedarf. Es sollte mit geeigneten Methoden, wie beispielsweise dem Freiburger Endophthalmitis-Set, ein Keimnachweis erfolgen. Bei der …

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Die bestmögliche Wundheilung der Kornea, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist oberstes Gebot, um einer dauerhaften Schädigung der Hornhaut frühzeitig entgegenzuwirken und die Funktion des Auges zu erhalten.   

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.