Pars plana vitrectomy versus immunomodulatory therapy for intermediate uveitis: a prospective, randomized pilot study.
OBJECTIVE
Comparison of pars plana vitrectomy (PPV) with immunomodulatory therapy (IMT) for patients with intermediate uveitis (IU).


METHODS
A prospective, randomized pilot study was performed on patients with recalcitrant IU associated with degradation of visual acuity (VA) despite standard treatment. Outcome measures (VA, intraocular pressure, anterior chamber and vitreous cellular infiltrate) were collected.


RESULTS
Sixteen patients (18 eyes) were randomized to the PPV IMT group. Nine of 11 eyes (82%) treated with PPV showed resolution of inflammation at follow-up, at 5.93 years. Four of 7 eyes (57%) given IMT had persistent inflammation requiring subsequent PPV. PPV patients showed greater improvement in Snellen line, IOP, and vitreous cell reduction. Three PPV patients had cystoid macular edema (CME) initially; all resolved postoperatively. CME improved in 2 of 3 eyes using IMT.


CONCLUSIONS
A higher percentage of patients treated with PPV had improvement of uveitis compared to those given IMT. A multicentered clinical trial is needed to confirm and statistically validate these conclusions.
Quinones
Karina
K
Massachusetts Eye Research and Surgery Institution, Cambridge, MA, USA.
Choi
John Y
JY
Yilmaz
Taygan
T
Kafkala
Chrysanthi
C
Letko
Erik
E
Foster
C Stephen
CS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D002648:Child; D005128:Eye Diseases / Q000150:complications / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007429:Intraocular Pressure; D008269:Macular Edema / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome; D015867:Uveitis, Intermediate / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects / Q000379:methods*; D014822:Vitreous Body / Q000473:pathology; D055815:Young Adult
D007155:Immunologic Factors