LONG-TERM VISUAL OUTCOME AND COMPLICATIONS ASSOCIATED WITH PARS PLANITIS

Purpose: To identify the ocular complications and to statistically eva luate the possible association of pars planitis with multiple sclerosi s (MS) in a homogeneous population of pars planitis patients. Methods: The authors reexamined 36 patients and reviewed the records of an add itional 18 patients (total: 54 patients, 108 eyes) with idiopathic par s planitis. Results: The initial mean visual acuity of 20/46 (logMAR: 0.36 +/- 0.50) was not statistically different from the final mean vis ual acuity of 20/44 (logMAR: 0.34 +/- 0.45; P = 0.73), after a mean fo llow-up of 89.2 months. Complications included neovascularization with or without associated vitreous hemorrhage (7 eyes, 6.5%), moderate to severe cellophane retinopathy (7 eyes, 6.5%), chronic cystoid macular edema (CME) (9 eyes, 8.3%), visually significant cataracts (16 eyes, 14.8%), and retinal detachment (9 eyes, 8.3%). Significant lens opacif ication was associated with a greater risk of retinal detachment (P = 0.004). In four patients (7.4%), optic neuritis developed, and in an a dditional eight patients (14.8%) MS developed. Kaplan-Meier analysis o f these data showed a 16.2% +/- 6.2% risk of MS solely developing in p atients, and a 20.4% +/- 6.7% risk of either MS or optic neuritis deve loping, after 5 years of disease. The presence of periphlebitis at the time of pars planitis diagnosis increased the rate of development of these conditions (P = 0.002). Six patients (11.1%) had a family histor y positive for MS in a first-degree relative. Conclusions: This study demonstrates the overall favorable visual prognosis in patients with p ars planitis. Patients with significant cataract formation appear to b e at greater risk for retinal detachment. Periphlebitis at the time of diagnosis of pars planitis increases the risk of development of optic neuritis or MS. The strong association demonstrated between pars plan itis and MS in this study further supports a link between the two dise ase states.