Presentation
Results Median age at presentation was 8 years. 35 patients (71.4%) were male and 43 patients (87.7%) had bilateral disease. [bjo.bmj.com]
HLA-DR51 (HLA-DRB 5) was present in 16 (57.1%) of 28 patients vs. 6 (12%) of 50 controls (OR = 9.78, CI = 2.79--36.42, P =.0001). [ncbi.nlm.nih.gov]
Entire Body System
- Asymptomatic
An inflammatory disorder of the cilliary body in the uvea that affects healthy, younger individuals who are often asymptomatic. It has a long clinical course with relapses and remissions. Symptoms include mildly decreased vision and floaters. [ebi.ac.uk]
Mild asymptomatic inflammation is observed. Steroid injections are given as needed for symptomatic floaters or cystoid macular edema. Steroid eye drops are used for iritis. [eyecenters.com]
In childhood, the disease is largely asymptomatic until in a well advanced stage with markedly reduced vision. Lack of early diagnosis and treatment may lead to permanent visual loss and amblyopia. [ncbi.nlm.nih.gov]
Definition 1 An inflammatory disorder of the cilliary body in the uvea that affects healthy, younger individuals who are often asymptomatic. It has a long clinical course with relapses and remissions. [tititudorancea.com]
- Chills
She denies having pain, fevers, chills, night sweats, skin rashes, difficulty with urination, diarrhea, or constipation. She does have blurring, halos, and a burning sensation in both eyes, as well as some back pain. [morancore.utah.edu]
Respiratoric
- Pneumonia
[…] with a larger PDA include: Breathing difficulties soon after birth (especially in premature babies) Heart murmur: the heart sounds abnormal when a doctor listens with a stethoscope Rapid breathing Difficulty feeding and poor growth Lung infections (pneumonia [chop.edu]
Lymphoma Consider in age over 50 years old with intermediate or Posterior Uveitis Endophthalmitis Bloodborne infection with intraocular infection Patients typically present appearing toxic or septic Some cases may develop more insidiously Klebsiella Pneumonia [fpnotebook.com]
Gastrointestinal
- Diarrhea
> oral antibiotics -neuroborreliosis (CNS) affected --> intravenous therapy for 2-4wks -caused by tropheryma whippelii -can cause intermediate uveitis -symptoms: arthralgia, myalgia, fever, weight loss -predominant symptoms as GI -- >malabsorption & diarrhea [studyblue.com]
She denies having pain, fevers, chills, night sweats, skin rashes, difficulty with urination, diarrhea, or constipation. She does have blurring, halos, and a burning sensation in both eyes, as well as some back pain. [morancore.utah.edu]
Diarrhea, nausea, and GI ulceration are its potential side-effects. [ijo.in]
Patients with history of chronic or bloody diarrhea should be referred to a gastroenterologist.[36] In the elderly, primary intraocular lymphoma is the most important entity to be differentiated from pars planitis. [ncbi.nlm.nih.gov]
Skin
- Sweating
Symptoms of congestive heart failure include rapid breathing, feeding problems, slow weight gain, low energy, and cold, clammy sweating. [mottchildren.org]
[…] findings assoc with systemic disorders: 1. fever, fatigue, night sweats --> sarcoidosis & TB 2. loss of sensitivity/paresthesias of hand, arm or leg --> MS 3. dermatitis --> lyme disease, TB, syhilis 4. arthritis of knee --> l yme disease 5. contact [studyblue.com]
However, some infants may have symptoms such as: Fast breathing Poor feeding habits Rapid pulse Shortness of breath Sweating while feeding Tiring very easily Poor growth Babies with PDA often have a heart murmur that can be heard with a stethoscope. [medlineplus.gov]
Most commonly, an infant or child with PDA will have the following symptoms: sweating rapid and heavy breathing fatigue poor weight gain little interest in feeding In the rare case that PDA goes undetected, an adult with the defect may experience symptoms [healthline.com]
- Dermatitis
We examined 4 eyes in 4 patients with atopic dermatitis by ultrasound biomicroscopy, UBM. Allthe eyes had breaks in the nonpigmented ciliary epithelium. Retinal detachment was present in 2 eyes andabsent in 2. [webview.isho.jp]
[…] findings assoc with systemic disorders: 1. fever, fatigue, night sweats --> sarcoidosis & TB 2. loss of sensitivity/paresthesias of hand, arm or leg --> MS 3. dermatitis --> lyme disease, TB, syhilis 4. arthritis of knee --> l yme disease 5. contact [studyblue.com]
Diagnosis: Clinical • History • Clinical findings • Duration of symptoms, recurrences • Fever, fatigue or night sweats are typical signs - Sarcoidosis & TB • Loss of sensitivity or paresthesias of hands, arms or legs - Multiple sclerosis • Dermatitis, [slideshare.net]
Signs of dermatitis may point to Lyme disease, tuberculosis, or syphilis, whereas arthritis of the knee may suggest the possibility of Lyme's, disease, and contact with cats may raise the possibility of Bartonella infection. [1] A routine baseline workup [ijo.in]
- Night Sweats
[…] findings assoc with systemic disorders: 1. fever, fatigue, night sweats --> sarcoidosis & TB 2. loss of sensitivity/paresthesias of hand, arm or leg --> MS 3. dermatitis --> lyme disease, TB, syhilis 4. arthritis of knee --> l yme disease 5. contact [studyblue.com]
Diagnosis: Clinical • History • Clinical findings • Duration of symptoms, recurrences • Fever, fatigue or night sweats are typical signs - Sarcoidosis & TB • Loss of sensitivity or paresthesias of hands, arms or legs - Multiple sclerosis • Dermatitis, [slideshare.net]
She denies having pain, fevers, chills, night sweats, skin rashes, difficulty with urination, diarrhea, or constipation. She does have blurring, halos, and a burning sensation in both eyes, as well as some back pain. [morancore.utah.edu]
Fever, fatigue, or night sweats are typical signs of sarcoidosis and tuberculosis, whereas loss of sensitivity or paresthesias of the hands, arms, or legs are suggestive of possible MS. [ijo.in]
- Erythema
[…] spirochete (tick vector) -cases concentrated in NE, mid-atlantic & upper midwest of US -incidence highest in kids 15&U & adults 30-59 -has 3 stages: early localized, early disseminated, late persistent systemic manifestations of lyme disease - skin : erythema [studyblue.com]
Eyes
- Blurred Vision
Symptoms of pars planitis include blurred vision, floaters, flashes, redness of the eye and eye pain. [monmouthretina.com]
The Humphrey ultrasound biomicroscope was used for examination of the right eye of a 17-year-old boy, referred to our clinic because of blurred vision. The lens showed a posterior subcapsular cataract precluding fundus visualization. [ncbi.nlm.nih.gov]
Symptoms of Pars Planitis Symptoms experienced by patients with the condition include: Blurred vision and dark floating spots that interfere with the clarity of eyesight. [somerseteyesurgeon.co.uk]
Symptoms Floaters and blurred vision are the principal symptoms. Blurred vision may be due to vitreous infiltrates or cystoid macular oedema (CMO). Mild symptoms may exist for many months before the patient seeks medical attention. [opticianonline.net]
- Anterior Uveitis
Resources Other names: Iritis; Uveitis ; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis [checkorphan.org]
Iritis (Anterior Uveitis) http://drstevenodrich.com/iritis-anterior-uveitis/ Iritis, also called “anterior uveitis” is an inflammatory disorder of the iris, the colored portion of the eye that surrounds the pupil. [rul.sarkatvolley.net]
uveitis, uveitis anterior, Anterior uveitis (diagnosis), Anterior uveitis, NOS, Anterior uveitis [Ambiguous], Anterior uveitis (disorder), Anterior Uveitis Dutch voorste uveïtis, uveïtis anterior, Uveitis anterior German anteriore Uveitis, Uveitis anterior [fpnotebook.com]
Uveitis is usually classified by where it occurs in the eye. What is anterior uveitis? Anterior uveitis occurs in the front of the eye. It is the most common form of uveitis, predominantly occurring in young and middle-aged people. [nei.nih.gov]
- Visual Impairment
Visual acuity improved in all patients after treatment, with an average of 4 lines of improvement. Conclusions: : Pars planitis in pediatric patients may cause significant visual impairment, and its presentation may vary considerably. [iovs.arvojournals.org]
Although a subset of patients with pars planitis do not have macular edema or visual impairment and may be observed, the majority of patients need treatment. [entokey.com]
Complications Decreased Visual Acuity Severe Visual Impairment : 35% Legally blind: 10% Iris scarring Impaired pupillary movement Secondary Glaucoma XIII. [fpnotebook.com]
It may present with normal to severe visual impairment. [djo.org.in]
- Band-Shaped Keratopathy
Surgery in case of cataract, glaucoma, hypotony and band shaped keratopathy Reema Bansal: May approach it as follows:- 1. Oral corticosteroids (bilateral involvement) 2. [djo.org.in]
Presentation • Peripheral vasculitis • CME, Peripapillary retinal edema • Vitritis, Cyclitis • Vitreous hemorrhage • Band shaped keratopathy 13. [slideshare.net]
Common complications seen are: disc edema, CME, cataract, glaucoma, and band-shaped keratopathy. Epiretinal and neovascular membranes occur. [ijo.in]
- Enophthalmos
• Drop in VA due to vitritis, CME, progression of neovascularization at the vitreous base • Periocular steroids- – Long acting Methyl prednisone (40 mg ) – Triamcinolone acetonide (20 mg) • Complications- – Glaucoma – Cataract – Aponeurotic ptosis – Enophthalmos [slideshare.net]
Repeated injections may cause enophthalmos and orbital scarring. [ijo.in]
Neurologic
- Irritability
Overview Uveitis is swelling and irritation of the uvea, the middle layer of the eye. The uvea provides most of the blood supply to the retina. Symptoms Uveitis can affect one or both eyes. [checkorphan.org]
Symptoms of uveitis include eye redness and irritation; blurred vision; eye pain; and increased sensitivity to light. [visionaware.org]
She reported floaters present in her vision for the same time period with no flashes of light, pain or irritation. There was no history of trauma, headaches or tick bites. [digital.crojournal.com]
Also, because blood is pumped at high pressure through the patent ductus, the lining of the pulmonary artery may become irritated and inflamed. [childrenshospital.org]
- Paresthesia
[…] findings assoc with systemic disorders: 1. fever, fatigue, night sweats --> sarcoidosis & TB 2. loss of sensitivity/paresthesias of hand, arm or leg --> MS 3. dermatitis --> lyme disease, TB, syhilis 4. arthritis of knee --> l yme disease 5. contact [studyblue.com]
Diagnosis: Clinical • History • Clinical findings • Duration of symptoms, recurrences • Fever, fatigue or night sweats are typical signs - Sarcoidosis & TB • Loss of sensitivity or paresthesias of hands, arms or legs - Multiple sclerosis • Dermatitis, [slideshare.net]
Known toxic effects are nephrotoxicity, hypertension, gingival hyperplasia, GI upset and paresthesias. [ijo.in]
- Burning Sensation
She does have blurring, halos, and a burning sensation in both eyes, as well as some back pain. Her only medications are Durezol and Voltaren eye medications, which she was prescribed when diagnosed with uveitic glaucoma. [morancore.utah.edu]
- Tingling
She denied any tingling, pain or lack of coordination. Uncorrected visual acuity was 6/7.5-2 (20/25-2) right eye and 6/6 (20/20) left eye at both distance and near. Pupils were equal, round, reactive to light with no afferent pupillary defect. [digital.crojournal.com]
The numbness starts with tingling. When I am trying to grab something, I am unable to grab it. I also suffer from worsening cognitive function as I... Read Full » Dr. Aida Quka Neurologist Answer: Hi, Welcome to icliniq.com. [icliniq.com]
Workup
The diagnosis workup including blood work, MRI, and neurological exam were ordered; results, treatment, and prognosis for this case is discussed. [aaopt.org]
However, even with a full diagnostic workup, a large proportion of IU cases remain idiopathic. There are numerous causes of intermediate uveitis, and this makes its epidemiology difficult to evaluate. [morancore.utah.edu]
Systemic workup for conditions associated with intermediate uveitis including sarcoidosis evaluation was negative. [joii-journal.springeropen.com]
Although most pediatric IU cases are idiopathic, a systemic workup is recommended to evaluate for underlying disorders (see “Possible Etiologies”). [aao.org]
Signs of dermatitis may point to Lyme disease, tuberculosis, or syphilis, whereas arthritis of the knee may suggest the possibility of Lyme's, disease, and contact with cats may raise the possibility of Bartonella infection. [1] A routine baseline workup [ijo.in]
Microbiology
- Borrelia Burgdorferi
[…] sarcoidosis 2. multiple sclerosis : most common cause of intraocular inflammation 3. toxocariasis 4. syphilis --> rule out with every uveitis pt 5. lyme disease 6. whipple's disease 7. tuberculosis 8. cat-scratch lyme disease and intermediate uveitis -borrelia [studyblue.com]
• IU has been described to occur in Lyme's disease caused by another spirocheate- Borrelia burgdorferi, both in adults and in children 24. [slideshare.net]
Serological tests for HIV, Toxoplasma gondii, Borrelia burgdorferi or Treponema pallidum were negative, as well as for antinuclear (ANA) and antineutrophil cytoplasmatic (ANCA) antibodies. He was diagnosed with bilateral pars planitis. [bmcophthalmol.biomedcentral.com]
Common infectious causes include Borrelia burgdorferi, Mycobacterium tuberculosis, Toxocara canis, Tropherema whipplei, Treponema pallidum, EBV, HTLV1, HIV, and Chikungunya. [morancore.utah.edu]
Treatment
[…] a destructive and painful procedure.To decrease the number of cryopexy treatments needed, we propose using Avastin, an agent with anti-inflammatory properties, as an adjunctive treatment for pars planitis. [iovs.arvojournals.org]
Three patients (five eyes) received scatter diode or argon photocoagulation treatment alone. [ncbi.nlm.nih.gov]
The main indications for starting immunosuppressive therapy were lack of response to initial treatment and advance disease at presentation. [bjo.bmj.com]
After treatment the visual acuity improved in 58 of the eyes, did not change in 33, and worsened in 9. [link.springer.com]
Prognosis
PURPOSE: To report the demographics and clinical characteristics, therapy logarithm, and prognosis of children with pars planitis. [ncbi.nlm.nih.gov]
PURPOSE To report the demographics and clinical characteristics, therapy logarithm, and prognosis of children with pars planitis. [healio.com]
A good prognosis can be expected for those who undergo appropriate treatment. The condition does not usually lead to permanent blindness Complications, such as glaucoma and cataract, can worsen the prognosis. [dovemed.com]
Etiology
Clinical and histopathological findings suggest an autoimmune etiology, most likely as a reaction to endogenous antigen of unknown source, with T cells predominant in both vitreous and pars plana infiltrations. [ncbi.nlm.nih.gov]
Although an autoimmune process with a genetic predisposition has been suggested, its etiology still remains unknown. The most common presenting symptoms are floaters and blurred vision. [semanticscholar.org]
Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system that is presumed to be an autoimmune etiology. [aaopt.org]
Epidemiology
Pars Planitis: Epidemiology, Clinical Characteristics, Management and Visual Prognosis., Ozdal PC,Berker N,Tugal-Tutkun I,, Journal of ophthalmic & vision research, 2015 Oct-Dec [PubMed] Standardization of uveitis nomenclature for reporting clinical data [knowledge.statpearls.com]
Pars planitis: epidemiology and clinical outcome in a large community hospital in Mexico city. [link.springer.com]
The immunogenetic association has been suggested by studies citing association of HLA-B51, HLA-DR2, HLA-DR15,[3] and HLA-DRB1*0802 haplotypes with pars planitis.[2] Epidemiology In a prospective epidemiology study of 215 uveitis patients, Vadot et al. [statpearls.com]
METHODS: Multicenter study using the Rochester Epidemiology Project medical records linkage system, which allows analysis of almost all patients within Olmsted County, Minnesota, with a given medical condition. [ncbi.nlm.nih.gov]
@article{Ozdal2015ParsPE, title={Pars Planitis: Epidemiology, Clinical Characteristics, Management and Visual Prognosis}, author={Pinar Cakar Ozdal and Nilufer Berker and Ilknur Tugal-Tutkun}, journal={Journal of Ophthalmic & Vision Research}, year={2015 [semanticscholar.org]
Pathophysiology
It is evident that genetics plays some role in the pathophysiology of intermediate uveitis, but the importance remains unclear. [en.wikipedia.org]
• The pathophysiology of IU/pars planitis is not well understood – It is probably an autoimmune reaction against an ocular antigen • Peripheral retinal veins are the primary foci for inflammation COMMONLY ASSOCIATED CONDITIONS • Sarcoidosis • Multiple [entokey.com]
Here, we report a case of peripapillary CNV in a patient with intermediate uveitis and explore the pathophysiology and outcome of this condition. [joii-journal.springeropen.com]
[…] exists.[5] MS has been characterized into four different subtypes, which include relapsing/remitting, primary progressive, secondary progressive and relapsing progressive, depending on the time course and progression of neurologic disability.[6] The pathophysiology [medscape.com]
Prevention
Prevention Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease. Diagnosis A complete medical history and eye examination should be performed. [checkorphan.org]
Anti-inflammatory medication in the form of eye drops, pills, or injections is usually recommended to alleviate pain, prevent further tissue damage and restore loss of vision. [monmouthretina.com]
Azathioprine • Purine nucleoside analogue • Alters purine metabolism • 50-150 mg per day • GI upset and hepatotoxicity Mycophenolate mofetil • Inhibits purine synthesis • Prevents replication of T and B lymphocytes • 1-3 mg per day • Mycophenolate is [slideshare.net]
In order to prevent these vision blinding complications patients need alternative therapies. What Causes Pars Planatis? The most common cause of Pars Planitis is idiopathic or autoimmune. [eyesurgeonsnyc.com]