Pars Plana Vitrectomy versus Immunomodulatory Therapy for Intermediate Uveitis: A Prospective, Randomized Pilot Study

Purpose: Comparison of pars plana vitrectomy (PPV) with immunomodulatory therapy (IMT) for patients with intermediate uveitis (IU). Methods: A prospective, randomized pilot study was performed on patients with recalcitrant IU associated with degradation of visual acuity (VA) despite standard treatme...

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Bibliographic Details
Published in:Ocular immunology and inflammation 2010-10, Vol.18 (5), p.411-417
Main Authors: Quinones, Karina, Choi, John Y., Yilmaz, Taygan, Kafkala, Chrysanthi, Letko, Erik, Foster, C. Stephen
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anterior Chamber - pathology
chemotherapy
Child
Eye Diseases - complications
Eye Diseases - pathology
Female
Follow-Up Studies
Humans
Immunologic Factors - therapeutic use
Intraocular Pressure
Macular Edema - complications
Macular Edema - drug therapy
Male
Middle Aged
pars planitis
Pilot Projects
remission
Retreatment
Time Factors
Treatment Outcome
uveitis
Uveitis, Intermediate - complications
Uveitis, Intermediate - pathology
Uveitis, Intermediate - physiopathology
Uveitis, Intermediate - therapy
Visual Acuity
vitrectomy
Vitrectomy - adverse effects
Vitrectomy - methods
Vitreous Body - pathology
Young Adult
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Summary:Purpose: Comparison of pars plana vitrectomy (PPV) with immunomodulatory therapy (IMT) for patients with intermediate uveitis (IU). Methods: A prospective, randomized pilot study was performed on patients with recalcitrant IU associated with degradation of visual acuity (VA) despite standard treatment. Outcome measures (VA, intraocular pressure, anterior chamber and vitreous cellular infiltrate) were collected. Results: Sixteen patients (18 eyes) were randomized to the PPV IMT group. Nine of 11 eyes (82%) treated with PPV showed resolution of inflammation at follow-up, at 5.93 years. Four of 7 eyes (57%) given IMT had persistent inflammation requiring subsequent PPV. PPV patients showed greater improvement in Snellen line, IOP, and vitreous cell reduction. Three PPV patients had cystoid macular edema (CME) initially; all resolved postoperatively. CME improved in 2 of 3 eyes using IMT. Conclusions: A higher percentage of patients treated with PPV had improvement of uveitis compared to those given IMT. A multicentered clinical trial is needed to confirm and statistically validate these conclusions.
ISSN:0927-3948
1744-5078
DOI:10.3109/09273948.2010.501132