EARLY VITRECTOMY IN ENDOGENEOUS JUVENILE INTERMEDIATE UVEITIS - A LONG-TIME FOLLOW-UP-STUDY

Background The intermediate uveitis is one of the most common intraocu lar manifestations of inflammation during infancy and adolescence. The success of intensive pharmacological treatment is rather limited and often associated with heavy side effects. Patients and methods In 25 e yes with juvenile uveitis intermedia (age of the patients between 5 an d 18 years, mean 13.5 years) and visual acuities between 0.02 and 0.4 (mean 0.19) an early vitrectomy was performed after failure of conserv ative treatment and peripheral cryocoagulation. Results Almost all pat ients (22 out of 25) showed an improvement of visual acuity within the first 6 months of the surgery. Among the patients with a remarkable i mprovement of visual acuity 7 eyes had a chronic cystoid macular oedem a which showed a regression postoperatively. Additionally, the number and the course of inflammatory periods could be reduced postoperativel y. An increase of pre existing lens opacities, however, has not been n oticed even after a follow-up period of 10 years. Conclusions The resu lts show that an early vitrectomy in cases of juvenile uveitis interme dia often leads to a stabilization or an improvement of visual acuity and a regression of the inflammatory attacks (episodes). Therefore, in children and adolescents with endogenous uveitis intermedia a pars pl ana vitrectomy instead of a long-term systemic immunosuppression assoc iated with heavy side-effects should be considered.