Key Takeaways:
- Surgical intervention for pediatric pars planitis could also be needed if immunosuppression is ineffective.
- Know the issues of scleral buckling with or with out pars plana vitrectomy.
FORT LAUDERDALE, Fla. — In some instances of pediatric pars planitis, surgical intervention could also be needed, however potential issues should be thought-about, based on a speaker.
On the Retina World Congress, Lisa J. Faia, MD, mentioned a case wherein a 12-year-old affected person with irritation secondary to pars planitis initially confirmed enchancment after therapy with difluprednate adopted by dorzolamide, oral steroids and mycophenolate. After 1 yr, nonetheless, signs returned regardless of therapy with immunosuppressants.
Picture: Anthony DeFino
“The irritation improved, however inferior contraction began to develop over the following yr, and tractional retinal detachment progressed inferiorly,” Faia stated.
Faia determined to carry out scleral buckling with out pars plana vitrectomy (PPV) as a consequence of potential issues related to PPV, together with the development of cataract and elevated threat for proliferative vitreoretinopathy (PVR).
“Presently, his imaginative and prescient is doing properly, and he’s on adalimumab simply as soon as a month,” she stated.
In keeping with Faia, whereas PPV is an efficient strategy to scale back irritation that leaves room for future trabeculectomy, it might additionally make lifting the hyaloid in youthful sufferers tougher. Comparatively, scleral buckling relieves vitreomacular traction however is troublesome to carry out and should trigger refractive error in addition to amblyopia in some sufferers.
When contemplating a surgical strategy for uveitis, ophthalmologists ought to first carry out a biopsy for correct prognosis and prioritize treating vision-threatening etiologies and lowering irritation, Faia stated. She additionally highlighted the prevalence of retinal detachment in sufferers with pars planitis, which happens in about 10% of sufferers, in addition to the next charge of PVR.
Different well-known surgical issues of pars planitis embrace band keratopathy, cataract, glaucoma, epiretinal membrane, vitreous opacities and retinoschisis.
In keeping with Faia, surgical intervention in sufferers with pediatric uveitis “could also be required for structural modifications if immunosuppression isn’t sufficient. A restore relies upon not solely on age however is restricted to what you’re searching for. And, when potential, acquire quiescence of irritation.”
Sources/Disclosures
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Faia LJ. Surgical procedure in pediatric uveitis sufferers: When immunosuppression isn’t sufficient. Offered at: Retina World Congress; Could 8-11, 2025; Fort Lauderdale, Florida.
Disclosures:
Faia stories being on the audio system bureau for AbbVie, Allergan, ANI Prescribed drugs, Astellas, Genentech and Regeneron and the advisory board for EyePoint Prescribed drugs, Ocular Therapeutix and Regeneron.
