Clinical Study
Eye (2006) 20, 184–190. doi:10.1038/sj.eye.6701845; published online 1 April 2005
Vitrectomy for juvenile uveitis: prognostic factors for the long-term functional outcome
Summary statement: Chronic endogenous uveitis in children showed a beneficial long-term outcome after PPV, best predicted by preoperative visual acuity and the presence of CME
This work was presented in part at the symposium 'Eye Surgery/Vitrectomy – Past, Present and Future', 26.–28.2.2004, Bern, Switzerland
P Trittibach1, F Koerner1, G-M Sarra1 and J G Garweg1
1Division for Vitreoretinal Diseases, Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland
Correspondence: JG Garweg, Division for Vitreoretinal Diseases, Department of Ophthalmology, University of Bern, Inselspital, CH-3010 Bern, Switzerland. Tel: +41 31 632 95 65; Fax: +41 632 01 14. E-mail: justus.garweg@insel.ch
Received 1 November 2004; Accepted 5 January 2005; Published online 1 April 2005.
Abstract
Purpose
This study evaluated the long-term effect of pars plana vitrectomy (PPV) in children and adolescents with chronic uveitis on visual function, anatomical outcome, and the requirement of systemic treatment. Further, predictive preoperative factors associated with a beneficial visual outcome were assessed.
Methods
Retrospective review of 29 eyes of 23 consecutive paediatric and juvenile patients below 20 years of age with chronic uveitis who underwent a PPV for visually significant opacities in 25 eyes, vitreous haemorrhage in three eyes, and retinal detachment in one eye. The clinical diagnosis was chronic intermediate uveitis in 22 eyes and retinal vasculitis of different origin in seven eyes.
Results
LogMAR visual acuity improved from an average of 0.91 to 0.33 (P<0.001). Cystoid macular oedema (CME) was significantly reduced in eight of 10 eyes postoperatively (P=0.021). In the multiple regression analysis, a low preoperative logMAR visual acuity and the presence of a CME had a negative influence on the final logMAR visual acuity. Furthermore, the appearance of chronic uveitis relapses was significantly reduced from 15 eyes before to seven eyes after surgery (P=0.042).
Conclusions
PPV has a beneficial effect on the course and the complications of chronic uveitis in paediatric and juvenile patients with respect to the anatomical and visual outcome. Preoperative logMAR visual acuity and clinically significant CME were the most accurate predictors for the functional outcome.
Keywords:
pars plana vitrectomy, uveitis, children, prognostic factors, cystoid macular oedema
