Frühvitrektomie bei endogener juveniler Uveitis intermedia - Eine Langzeitstudie

Abstract

The results show that an early vitrectomy in cases of juvenile uveitis intermedia often leads to a stabilization or an improvement of visual acuity and a regression of the inflammatory attacks (episodes). Therefore, in children and adolescents with endogenous uveitis intermedia a pars plana vitrectomy instead of a long-term systemic immunosuppression associated with heavy side-effects should be considered.

Vitrectomy for juvenile uveitis: prognostic factors for the long-term functional outcome

“…These results compare well with other reports focusing on PPV in paediatric populations, where an increase of DVA from 0.19-0.3 preoperatively to 0.53-0.72 after surgery was achieved. [17][18][19] Furthermore, we found an improvement of the DVA in 86.2% of the eyes after PPV, which compares favourably with a recent meta-analysis of 58 scientific papers (1934 eyes) about PPV in adult uveitis patients, where a visual acuity improvement in 83% of the eyes was found. 23 Multiple regression analysis revealed that only two of the tested independent predictor variables, namely preoperative logMAR acuity and clinically present CME were significantly associated with the final postoperative logMAR acuity in our population.…”

“…Therefore, it seems generally accepted that PPV is a valuable therapeutic approach in paediatric uveitis. [17][18][19] The follow-up times of these studies, however, were shorter than in our present series.…”

“…[17][18][19] A stable gain of more than 2 logMAR acuity lines was observed in more than two-thirds of the eyes and maintained over a follow-up of more than 6 years, which is clearly beyond previous studies. The logMAR visual acuity in our study group improved significantly from 0.91 (DVA 0.12) to 0.3 (DVA 0.5) after PPV.…”

“…17,18 Several studies with adult patients showed a greater variation of the CME regression rate (32.4-82.4%). [4][5][6]9,10,12 The abovementioned meta-analysis showed a regression rate of 47.4% after PPV.…”

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16] There are only three reports focusing on therapeutic PPV in a paediatric population (in total 43 eyes) with chronic uveitis. [17][18][19] All three groups reported a postoperative improvement in visual acuity, a CME reduction, and reduced rate of recurrences with a subsequently achieved reduction of the immunomodulatory therapy after follow-up times of 6 months to 10 years. Furthermore, all findings in juvenile populations are in agreement with the findings in adults with chronic endogenous uveitis after PPV.…”