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The role of pars plana vitrectomy in the diagnosis and treatment of uveitis.
- Source :
-
European journal of ophthalmology [Eur J Ophthalmol] 2011 Jan-Feb; Vol. 21 (1), pp. 89-97. - Publication Year :
- 2011
-
Abstract
- Purpose: To assess the diagnostic yield of vitreous fluid analysis and the therapeutic effect of pars plana vitrectomy in patients with suspected intraocular inflammation.<br />Methods: During 2004-2008, pars plana vitrectomy was performed in 89 patients (101 eyes) out of 1233 patients with uveitis. Vitreous specimens were analyzed by cytologic and histopathologic examination, microbiologic culture, polymerase chain reaction, antibody determination, and flow cytometry. Vitrectomy was performed in 85 eyes for both diagnostic and therapeutic purposes; the remaining 16 eyes underwent only diagnostic pars plana vitrectomy. Preoperative and postoperative best-corrected Snellen visual acuity was compared.<br />Results: Preoperative diagnoses were infection in 40 patients, malignant masquerade syndrome in 10 patients, and idiopathic uveitis in 39 patients. Vitreous analysis contributed to the determination of diagnosis in 54 patients (61%). Final diagnoses were infection in 42 patients, malignant masquerade syndrome in 6 patients, benign masquerade syndrome in 16 patients, and idiopathic uveitis in 25 patients. Vitreous fluid collected from each eye underwent approximately 2.2 (range 1-6) laboratory tests. Therapeutic reasons for vitrectomy were the treatment of complications of uveitis in 42 eyes and/or intravitreal application of anti-infectious or cytostatic drugs in 49 eyes. Overall, the visual acuity improved in 45% of eyes, remained unchanged in 45% of eyes, and decreased in 10% of eyes in 3 months after surgery.<br />Conclusions: Pars plana vitrectomy with carefully selected testing is a valuable tool for assessment of diagnosis in a large proportion of patients with uveitis. Moreover, the therapeutic effect of vitrectomy can improve the visual outcomes in these patients.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents administration & dosage
Antiprotozoal Agents administration & dosage
Antiviral Agents administration & dosage
Child
Coloring Agents
Female
Flow Cytometry
Fluorescein Angiography
Humans
Indocyanine Green
Male
Middle Aged
Polymerase Chain Reaction
Retrospective Studies
Visual Acuity physiology
Vitreous Body immunology
Vitreous Body microbiology
Young Adult
Eye Infections diagnosis
Eye Infections drug therapy
Uveitis diagnosis
Uveitis drug therapy
Vitrectomy
Vitreous Body pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1724-6016
- Volume :
- 21
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 20853259
- Full Text :
- https://doi.org/10.5301/ejo.2010.4040