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At least 19 recordsLinked to original sources

Cryopexy in pars planitis.

Cryotherapy has been reported to be of benefit in pars planitis. We studied 16 eyes with classic pars planitis unresponsive to corticosteroid therapy. Eight eyes continued with systemic and periocular steroid therapy, and in the remaining eight eyes transconjunctival cryopexy of the peripheral retina and vitreous base was done as an additional procedure. At 6 months four of the eyes that received cryopexy showed an improvement in Snellen visual acuity, and in the other four the acuity was unchanged; none of the eyes showed any vitreous base neovascularization. Among the eyes that received steroid therapy only, the acuity was unchanged in five, improved in one and reduced in two.

Adolescent

Pars planitis in father and son.

The authors examined a family in which father and son presented with pars planitis. Both of them and the paternal grandparents were HLA typed; no association between HLA antigens and pars planitis was found. Present and previous data suggest a relation between pars planitis and allergic predisposition.

Adrenal Cortex Hormones

[Origin of macular edema caused by pars planitis].

In four cases with clinical diagnosis of "pars planitis" fluorescein angiography was performed and macular area observed. Permeability disturbances were noted in retinal capillary area. This points to the vitreous changes being secondary to an inflammation of superficial retinal layers. For this reason in those conditions the name "hyalo-retinitis" used by Gärtner seems to be more correct than the limiting diagnosis of "pars planitis".

Adult

[Diathermy and cryotherapy of the pars plana in the treatment of pars planitis. Long-term evaluation].

Seventeen eyes of 14 patients affected with severe pars planitis underwent surgical treatment with either cryotherapy - 3 eyes - or diathermy - 14 eyes. The indications for surgery were selected as follows: ten eyes of 9 patients showed recurrence(s) or increase of ocular inflammation following tapering of systemic corticoids; 5 patients had contra-indications to systemic corticoids. Ten eyes had cystoid macular edema. The follow-up after surgery varies from 2,5 years to 10 years with an average of 5 years. Complete and permanent recovery from ocular inflammation was achieved in 7 eyes (41,2%). Permanent although incomplete improvement was achieved in 4 eyes (23,5%). Recurrences of ocular inflammation after incomplete improvement occurred in 4 eyes (23,5%). Complications - cystoid macular degeneration and severe ocular hypotension - occurred in 2 eyes (11,8%). Cystoid macular edema cleared in 9 out of 10 eyes. The final visual acuity was the same or better as compared to the initial visual acuity in 10 eyes, and worse in 7 eyes. It is concluded that the long term evaluation of cryotherapy and diathermy in the treatment of pars planitis confirms the results achieved in other series with a shorter follow-up. The treatment is beneficial in selected cases of severe pars planitis. However complete and permanent recovery from ocular inflammation should be expected in less than 50% of the cases.

Adolescent

Pathology of pars planitis.

Seven eyes and one vitrectomy specimen from seven patients with pars planitis and complications such as secondary glaucoma and phthisis bulbi were studied histopathologically. Two of the specimens were also examined by electron microscopy. All cases showed a typical intravitreal "snowbank" opacity overlying the pars plana. On light microscopy, these "snowbanks" appeared to consist of a loose fibrovascular layer containing occasional fibrocyte-like cells and scattered mononuclear inflammatory cells adjacent to the hyperplastic nonpigmented epithelium of the pars plana. Within the vitreous base, an extensive fibroglial proliferation had developed, often drawing the peripheral retina anteriorly into the "snowbank." Electron microscopy showed this fibroglial tissue to be composed of condensed vitreous collagen and probable fibrous astrocytes which had produced larger-diameter (about 24 mm) collagen fibrils. The fibroglial proliferation also appeared continuous with an ultrastructurally similar preretinal fibroglial membrane. All eyes showed prominent lymphocytic cuffing and mural infiltration of retinal veins, with sparing of the arterioles. Several cases showed cystoid macular edema. Only mild choroiditis or cyclitis could be shown in some cases. We believe that in pars planitis the fibroglial "snowbank" may reflect a common inflammatory process involving both the peripheral retina and vitreous base.

Adolescent

Neovascularization of the disc in pars planitis.

Neovascularization of the disc (NVD) was present in 9 of 163 patients with pars planitis. In all cases, NVD was unilateral and observed in eyes with recent exacerbation of the inflammatory process. To reduce intraocular inflammation, all nine eyes were treated with varying combinations of topical, periocular, and systemic corticosteroids. In addition to corticosteroids, one eye received Argon laser photocoagulation, two eyes underwent peripheral cryotherapy, and one eye was treated with both Argon laser photocoagulation and peripheral cryotherapy. With decrease or disappearance of intraocular inflammation, NVD resolved in all cases without recurrence during follow-up study, which ranged from 6 to 189 (mean, 81) months. Rhegmatogenous retinal detachments developed in two eyes treated with peripheral cryotherapy. Both detachments were successfully repaired with surgery. Control of intraocular inflammation appears to be the key factor for regression of NVD in pars planitis. If NVD does not regress or vitreous hemorrhage occur, photocoagulation and peripheral cryotherapy may be beneficial.

Adolescent

Fibroglial proliferation in pars planitis.

In a 51-year-old patient with long-standing pars planitis, light and electron microscopical examination of the intravitreal 'snowbank' revealed a fibrovascular layer adjacent to the hyperplastic nonpigmented epithelium of the pars plana and an extensive fibroglial proliferation within the vitreous base. The fibrovascular layer consisted of well-differentiated capillaries, probably emanating from the peripheral retina, interspersed with aggregated vitreous fibrils. The fibroglial portion of the 'snowbank' was composed of fibrous astrocyte-like cells which had secreted basement membranes and larger diameter collagen fibrils. This fibroglial tissue was in direct continuity with an ultrastructurally similar preretinal membrane. No significant choroiditis or cyclitis could be demonstrated. It is hypothesized that, in pars planitis, a primary inflammatory process of the peripheral retina and vitreous base may stimulate the observed preretinal and intravitreal fibroglial proliferation.

Ciliary Body

Pars planitis.

The records on thirty-three patients (58 eyes) with the diagnosis of pars planitis were reviewed. The patients were divided into 4 groups: Group 1 had bilateral vitreous cells and pars plana 'snowbank' formation (13 patients, 26 eyes), Group 2 had bilateral vitreous cells and 'snowbank' formation in one eye only (8 patients, 16 eyes), Group 3 had vitreous cells and 'snowbank' formation in one eye only (8 patients, 8 eyes), and Group 4 had bilateral vitreous cells without 'snowbank' formation (4 patients, 8 eyes). Frequent findings and complications were tabulated; cystoid macular oedema was the most common cause of decreased vision. Although pars plana 'snowbank' exudates are usually present in pars planitis, they may not be necessary to make the diagnosis. An approach to therapy is outlined.

Adolescent

Clinical and immunopathological studies of pars planitis in a family.

We examined a family in which two brothers with identical HLA typing have pars planitis with snowbanking. Immunopathological studies of one of their eyes showed that in the area of snowbanking over the pars plana there was mild to moderate inflammatory cell infiltration, consisting of mostly Pan T (Leu 4+) lymphocytes. The ratio of T helper/inducer to T suppressor/cytotoxic cells was approximately 10:1. Few macrophages (OKM1+) were identified. Very few B cells and no NK cells were observed. Some retinal vessels had a perivascular infiltration consisting of mostly T lymphocytes. Most of the inflammatory cells bore class II antigens (HLA-DR+), while T cells bore few IL-2 receptors (anti-TAC+). The snowbank consisted mainly of glial elements (GFAP+) and basement membrane components (type IV collagen and laminin) with the predominant cell the Müller cell (Mü+). A site of inflammation at the iris-ciliary body junction also stained for B cells (Leu 14+). These findings suggest that the snowbank could be formed by the glial elements of the peripheral retina. The chronic inflammation in pars planitis appears to consist of helper T cells, both in the pars plana, and the retinal vasculature.

Adolescent

The significance of the pars plana exudate in pars planitis.

We divided 61 patients (111 eyes) with pars planitis into three groups based on clinical appearance. Patients in Group I had bilateral vitreous cells and bilateral pars plana exudates (36 patients, 72 eyes); patients in Group II had bilateral vitreous cells but a pars plana exudate in one eye only (14 patients, 28 eyes); and patients in Group III had vitreous cells and exudate formation in the single eye involved (11 patients, 11 eyes). The presence of a pars plana exudate was associated with more severe vitreous disease and increased incidence of cystoid macular edema.

Adult

Pars planitis and autoimmune endotheliopathy.

A migrating endothelial rejection line is the clinical criterion of specific immune reaction in corneal allotransplantation. This line when seen in otherwise intact corneas has been presumed to be an autoimmune endotheliopathy. We have recorded corneal changes similar to autoimmune endotheliopathy in four of ten patients with the diagnosis of pars planitis. These observations suggest that pars planitis may be an autoimmune process directed against the vitreous humor.

Adult

Treatment of pars planitis with cryotherapy.

Cryotherapy was performed on 28 eyes exhibiting massive exudates (snowbank) over the pars plana and the ora serrata. Twenty-six patients ranging in age from 8 to 52 years were treated and then followed up for a median of 34 months. Eleven eyes needed repeat cryotherapy. After cryotherapy, retinal vasculitis and vitreous opacities decreased in most eyes. Although only 3 of 5 eyes with a snowbank greater than 90 degrees and treated over 1 year from the onset achieved visual acuity of 20/25 or better, all 12 eyes with a snowbank smaller than 60 degrees and treated within 3 months after the onset maintained a visual acuity of 20/25 or better. The prognosis was not different from the 20 eyes that received systemic steroid treatment and the 8 eyes that received no systemic steroids. We recommend cryotherapy as the primary treatment for pars planitis with a snowbank.

Adolescent

Lens implant surgery in pars planitis.

Intraocular lens (IOL) implantation is usually contraindicated in eyes with active inflammation, but patients with "burned-out" pars planitis also may be considered as candidates. Fifteen of 16 eyes in eight patients underwent extracapsular cataract extraction (ECCE) with posterior chamber IOL (PC IOL) implantation combined with pars plana vitrectomy for both cataracts and chronic cystoid macular edema (CME); 60% achieved visual acuity of 20/40 or better. Even with "low-grade" inflammation in these patients, however, a persistent veil of debris accumulated over the posterior and anterior surface of the IOL. One patient (patient 2) required 27 YAG procedures for two eyes, and another required 11 YAG procedures and eventual removal of the IOL. Another patient required surgical "brushing-off" of the IOL and vitrectomy. Even in eyes with "burned-out" uveitis, a continual low-grade inflammation may complicate the use of IOL implantation.

Adult

[Basal uveo-retinitis (peripheral uveitis, chronic posterior cyclitis, pars planitis, vitritis, hyalo-retinitis). and other inflammations of the peripheral retina].

The study of the histological features of the peripheral retina and the observation of this periphery in 149 cases of uveitis of various types has led us to consider these peripheral retinal inflammations as presenting clinically either as a local reaction in this area during the course of anterior and posterior uveitis, manifested by a circular inflammatory condensation of the peripheral vitreous, or as a specific affection related to the periphery. These latter assume two forms: either that of a peripheral chorio-retinitis, or that of a basal uveo-retinitis, a term proposed in place of those considered inadequate--pars planitis, peripheral uveitis, chronic posterior cyclitis. In accordance with this conception four forms of uveitis can be distinguished: anterior uveitis, posterior uveitis, peripheral chorio-retinitis and basal uveoretinitis.

Adolescent