Spectral domain optical coherence tomography findings of patients with pars planitis and risk factors affecting visual acuity

Abstract

Purpose

To evaluate spectral domain optical coherence tomography (SD-OCT) findings of 42 eyes with pars planitis and to identify risk factors affecting visual acuity.

Methods

Medical records and SD-OCT findings were retrospectively reviewed.

Results

Mean best-corrected visual acuity (BCVA) was 0.248 ± 0.3 on the logMAR scale at baseline. SD-OCT findings included epiretinal membrane (ERM) in 16 (38.1%) eyes, loss of normal foveal contour appearance in 8 (19.0%), ellipsoid zone (EZ) damage in 5 (11.9%), external limiting membrane (ELM) damage in 3 (7.1%), disruption of retinal pigment epithelium (RPE) in 2 (4.8%), and macular atrophy in 1 (2.4%). There was macular edema in 10 (23.8%) eyes [cystoid macular edema (CME) in 8 (19.0%), diffuse macular edema (DME) in 6 (14.3%), and serous retinal detachment in 2 (4.8%)]. The mean central macular thickness (CMT) was 272.1 ± 319.5 μm. Patients were followed up for a mean of 50.6 ± 36.7 months. Mean BCVA was 0.210 ± 0.3 at the final evaluation. SD-OCT findings included ERM in 28 (66.7%) eyes, EZ damage in 6 (14.3%), ELM damage in 3 (7.1%), disruption of RPE in 4 (9.5%), loss of normal foveal contour appearance in 12 (28.6%), and macular atrophy in 2 (4.8%). There was CME and/or DME in 6 (14.3%) eyes. The mean CMT was 238 ± 220.9 μm and was significantly lower than the baseline (p < 0.001). According to multivariate linear regression analysis, the presence of DME, and loss of normal foveal contour appearance at baseline were the independent factors associated with BCVA at the final examination (B = 0.726, p < 0.001; B = 0.766, p < 0.001, respectively).

Conclusions

DME and loss of normal foveal contour appearance were more likely to have adverse effects on visual acuity.

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References

  1. 1.

    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 ınternational workshop. Am J Ophthalmol 140(3):509–516. https://doi.org/10.1016/j.ajo.2005.03.057

  2. 2.

    Guest S, Funkhouser E, Lightman S (2001) Pars planitis: a comparison of childhood onset and adult onset disease. Clin Exp Ophthalmol 29(2):81–84. https://doi.org/10.1046/j.1442-9071.2001.d01-7.x

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    Ozdal PC, Sen E, Yazici A, Ozturk F (2012) Patterns of childhood-onset uveitis in a referral center in Turkey. J Ophthalmic Inflamm Infect 2(1):13–19. https://doi.org/10.1007/s12348-011-0044-8

    Article  PubMed  Google Scholar 

  4. 4.

    Paroli MP, Spinucci G, Liverani M, Monte R, Pezzi PP (2009) Uveitis in childhood: an Italian clinical and epidemiological study. Ocul Immunol Inflamm 17(4):238–242. https://doi.org/10.1080/09273940802702561

    Article  PubMed  Google Scholar 

  5. 5.

    Smith JA, Mackensen F, Sen HN et al (2009) Epidemiology and course of disease in childhood uveitis. Ophthalmology 116(8):1544–1551. https://doi.org/10.1016/j.ophtha.2009.05.002

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Yalçındağ FN, Özdal PC, Özyazgan Y, Batıoğlu F, Tugal-Tutkun I, BUST Study Group (2018) Demographic and clinical characteristics of Uveitis in Turkey: the first national registry report. Ocul Immunol Inflamm 26(1):17–26. https://doi.org/10.1080/09273948.2016.1196714

    Article  PubMed  Google Scholar 

  7. 7.

    Paroli MP, Spinucci G, Monte R, Pesci FR, Abicca I, Pezzi PP (2011) Intermediate uveitis in a pediatric Italian population. Ocul Immunol Inflamm 19(5):321–326. https://doi.org/10.3109/09273948.2011.603878

    Article  PubMed  Google Scholar 

  8. 8.

    Romero R, Peralta J, Sendagorta E, Abelairas J (2007) Pars planitis in children: epidemiologic, clinical, and therapeutic characteristics. J Pediatr Ophthalmol Strabismus 44(5):288–293. https://doi.org/10.3928/01913913-20070901-03

    Article  PubMed  Google Scholar 

  9. 9.

    Tugal-Tutkun I (2011) Pediatric uveitis. J Ophthalmic Vis Res 6(4):259–269

    PubMed  PubMed Central  Google Scholar 

  10. 10.

    Donaldson MJ, Pulido JS, Herman DC, Diehl N, Hodge D (2007) Pars planitis: a 20-year study of incidence, clinical features, and outcomes. Am J Ophthalmol 144(6):812–817. https://doi.org/10.1016/j.ajo.2007.08.023

    Article  PubMed  Google Scholar 

  11. 11.

    Nikkhah H, Ramezani A, Ahmadieh H et al (2011) Childhood pars planitis; clinical features and outcomes. J Ophthalmic Vis Res 6(4):249–254

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Rosenberg KD, Feuer WJ, Davis JL (2004) Ocular complications of pediatric uveitis. Ophthalmology 111(12):2299–2306. https://doi.org/10.1016/j.ophtha.2004.06.014

    Article  PubMed  PubMed Central  Google Scholar 

  13. 13.

    de Boer J, Steijaert A, van den Bor R, Stellato R, Norel JO (2015) Development of macular edema and impact on visual acuity in uveitis associated with juvenile idiopathic arthritis. Ocul Immunol Inflamm 23(1):67–73. https://doi.org/10.3109/09273948.2013.871566

    Article  PubMed  Google Scholar 

  14. 14.

    Salcedo-Villanueva G, Arellanes-Garcia L, Fromow-Guerra J, Hernández-Quintela E (2014) Association of epiretinal membranes with macular edema in pars planitis. Arch Soc Esp Oftalmol 89(1):22–26. https://doi.org/10.1016/j.oftal.2013.09.008

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Grajewski RS, Boelke AC, Adler W, Meyer S, Caramoy A, Kirchhof B, Cursiefen C, Heindl LM (2016) Spectral-domain optical coherence tomography findings of the macula in 500 consecutive patients with uveitis. Eye (Lond) 30(11):1415–1423. https://doi.org/10.1038/eye.2016.133

    CAS  Article  Google Scholar 

  16. 16.

    Roesel M, Henschel A, Heinz C, Spital G, Heiligenhaus A (2008) Time-domain and spectral-domain optical coherence tomography in uveitic macular edema. Am J Ophthalmol 146(4):626–627. https://doi.org/10.1016/j.ajo.2008.06.023

    Article  PubMed  Google Scholar 

  17. 17.

    Lehpamer B, Moshier E, Pahk P, Goldberg N, Ackert J, Godbold J, Jabs DA (2014) Epiretinal membranes in uveitic macular edema: effect on vision and response to therapy. Am J Ophthalmol 157(5):1048–1055. https://doi.org/10.1016/j.ajo.2014.01.020

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Hee MR, Puliafito CA, Wong C, Duker JS, Reichel E, Rutledge B, Schuman JS, Swanson EA, Fujimoto JG (1995) Quantitative assessment of macular edema with optical coherence tomography. Arch Ophthalmol 113(8):1019–2029. https://doi.org/10.1001/archopht.1995.01100080071031

    CAS  Article  PubMed  Google Scholar 

  19. 19.

    Cunningham ET Jr, van Velthoven ME, Zierhut M (2014) Spectral-domain-optical coherence tomography in uveitis. Ocul Immunol Inflamm 22(6):425–428. https://doi.org/10.3109/09273948.2014.982060

    Article  PubMed  Google Scholar 

  20. 20.

    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(4):616–621. https://doi.org/10.1016/j.ajo.2005.09.035

    Article  PubMed  Google Scholar 

  21. 21.

    Prieto JF, Dios E, Gutierrez JM, Mayo A, Calonge M, Herreras JM (2001) Pars planitis: epidemiology, treatment, and association with multiple sclerosis. Ocul Immunol Inflamm 9(2):93–102. https://doi.org/10.1076/ocii.9.2.93.3975

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Arellanes-García L, Navarro-López L, Recillas-Gispert C (2003) Pars planitis in the Mexican Mestizo population: ocular findings, treatment, and visual outcome. Ocul Immunol Inflamm 11(1):53–60. https://doi.org/10.1076/ocii.11.1.53.15583

    Article  PubMed  Google Scholar 

  23. 23.

    Sancho L, Kramer M, Koriat A, Eiger-Moscovich M, Sharon Y, Amer R (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(3):447–455. https://doi.org/10.1080/09273948.2017.1420203

    Article  PubMed  Google Scholar 

  24. 24.

    Navarrete A, Koriat A, Amer R (2020) Implications of pars planitis-associated cystoid macular edema on visual outcome and management in children. Graefes Arch Clin Exp Ophthalmol 258(8):1803–1811. https://doi.org/10.1007/s00417-020-04696-7

    Article  PubMed  Google Scholar 

  25. 25.

    Jain R, Ferrante P, Reddy GT, Lightman S (2005) Clinical features and visual outcome of intermediate uveitis in children. Clin Exp Ophthalmol 33(1):22–25. https://doi.org/10.1111/j.1442-9071.2005.00938.x

    Article  PubMed  Google Scholar 

  26. 26.

    Eser-Ozturk H, Sullu Y (2020) Pediatric uveitis in a referral center in north part of Turkey. Ocul Immunol Inflamm 28:1–5. https://doi.org/10.1080/09273948.2020.1758158

    Article  Google Scholar 

  27. 27.

    Malinowski SM, Pulido JS, Folk JC (1993) Long-term visual outcome and complications associated with pars planitis. Ophthalmology 100(6):818–824. https://doi.org/10.1016/s0161-6420(93)31567-8

    CAS  Article  PubMed  Google Scholar 

  28. 28.

    Reiff A (2020) Clinical presentation, management, and long-term outcome of pars planitis, panuveitis, and Vogt-Koyanagi-Harada disease in children and adolescents. Arthritis Care Res (Hoboken) 72(11):1589–1596. https://doi.org/10.1002/acr.24056

    Article  Google Scholar 

  29. 29.

    Markomichelakis N, Halkiadakis I, Pantelia E et al (2004) Patterns of macular edema in patients with uveitis: qualitative and quantitative assessment using optical coherence tomography. Ophthalmology 111(5):946–952. https://doi.org/10.1016/j.ophtha.2003.08.037

    Article  PubMed  Google Scholar 

  30. 30.

    Iannetti L, Tortorella P, D’Ambrosio E, Spena R, Zito R, Gharbiya M (2013) Epiretinal membranes in patients with uveitis: morphological and functional analysis with spectral domain optical coherence tomography. BioMed Res Int 2013:284821. https://doi.org/10.1155/2013/284821

    Article  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Massamba N, Jennifer ML, Lehoang P, Sellam A, Bodaghi B (2017) Analysis of outer nuclear and external limiting membrane layers pattern on spectral-domain optical coherence tomography ın patients with posterior uveitis with or without cystoid macular edema. J Ophthalmol Clin Res 4:37. https://doi.org/10.24966/OCR-8887/100037

    Article  Google Scholar 

  32. 32.

    Gonzales CA, Ladas JG, Davis JL, Feuer WJ, Holland GN (2001) Relationships between laser flare photometry values and complications of uveitis. Arch Ophthalmol 119(12):1763–1769. https://doi.org/10.1001/archopht.119.12.1763

    CAS  Article  PubMed  Google Scholar 

  33. 33.

    Davis JL, Dacanay LM, Holland GN, Berrocal AM, Giese MJ, Feuer WJ (2003) Laser flare photometry and complications of uveitis in children. Am J Ophthalmol 135(6):763–771. https://doi.org/10.1016/s0002-9394(03)00315-5

    Article  PubMed  Google Scholar 

  34. 34.

    Eiger-Moscovich M, Tomkins-Netzer O, Amer R, Habot-Wilner Z, Kasb A, Friling R, Kramer M (2019) Visual and clinical outcome of macular edema complicating pediatric noninfectious uveitis. Am J Ophthalmol 202:72–78. https://doi.org/10.1016/j.ajo.2019.02.011

    Article  PubMed  Google Scholar 

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Funding

SD-OCT device was supported by the Ankara University Scientific Projects (Project number: 15A0230008).

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Correspondence to Emine Temel.

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The authors declare that they have no conflict of interest.

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Our study was performed in adherence to the tenets of the Declaration of Helsinki. No institutional review board approval is required for chart review studies.

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Informed consent was obtained from all individual participants included in the study.

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Yalçındağ, F.N., Temel, E. & Özgür, E.G. Spectral domain optical coherence tomography findings of patients with pars planitis and risk factors affecting visual acuity. Int Ophthalmol (2021). https://doi.org/10.1007/s10792-021-01734-z

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Keywords

  • Cystoid macular edema
  • Diffuse macular edema
  • Pars planitis
  • Spectral domain optical coherence tomography
  • Uveitis