Clinical Features, Complications, and Treatment Outcomes of Pediatric Pars Planitis Cases in a Tertiary Referral Center.

Abstract

Purpose: To present the clinical manifestations, ocular complications and treatment results of pediatric pars planitis (PPP).

Methods: This retrospective clinical study was conducted at a tertiary care center and included 28 children (51 eyes) aged 16 years or younger. Visual acuity (VA), anterior chamber cell (ACC) grade, vitritis grade, central macular thickness (CMT), fundus fluorescein angiography (FFA) score, treatment approach, complications, and relapse rate were recorded. All data were analyzed for baseline, third month, sixth month, ninth month, and twelfth month.

Results: The mean or median follow-up duration was 12 months. A total of twenty patients (71%) were administered Methotrexate (MTX) and the mean MTX dosage was 8.6 ± 1.1 mg. Ten patients (35%) were administered corticosteroid, and the mean dosage was 29.6 ± 4.2 mg. Adalimumab was administered to 16 patients (57%). There was a significant improvement in VA (-0.068, p = 0.025) during the first 3 months of follow-up. There were no significant changes in the VA during the subsequent follow-up periods. ACC grade decreased significantly in the third month (-0.765, p < 0.001), while vitritis grade decreased significantly in the sixth month (-0.502, p < 0.001). There was no significant change in CMT in all study eyes during the follow-up periods. However, there was macular edema in 14 eyes (27%) in baseline examination. After treatment, CMT was lower than 250 µm in 8 eyes (57%) in the last follow-up.

Conclusion: Immunosuppressive therapy is effective in suppressing intraocular inflammation. Treatment should be aimed at controlling inflammation, macular edema, and papillitis. Early diagnosis and aggressive treatment are important for a good visual prognosis.