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Pars Planitis

Peripheral Uveitis


Presentation

  • Patients with pars planitis may present with bullous retinoschisis and/or exudative retinal detachment.[ncbi.nlm.nih.gov]
Falling
  • Intermediate uveitis falls into the category of "vitritis" for purpose of differential diagnosis and therefore has to be differentiated from sarcoidosis, amyloidosis, active retinitis and recent trauma.[docksci.com]
  • Vitreous inflammation leads to exudate and cytokine formation, which mainly falls to the inferior eye, eliciting an endotheliopathy-like reaction.[crimsonpublishers.com]
Amyloidosis
  • Intermediate uveitis falls into the category of "vitritis" for purpose of differential diagnosis and therefore has to be differentiated from sarcoidosis, amyloidosis, active retinitis and recent trauma.[docksci.com]
  • Systemic associations of intermediate uveitis include sarcoidosis, multiple sclerosis (MS) and Lyme disease.2-4 Lesser associations include Behcet’s disease, syphilis, amyloidosis, familial exudative vitreoretinopathy, toxocariasis, toxoplasmosis, candidiasis[digital.crojournal.com]
Collapse
  • The snowbank consisted of posteriorly detached and collapsed vitreous in which cellular proliferation from the retina with non-pigmented ciliary epithelium was present.[ncbi.nlm.nih.gov]
Weight Gain
  • After a short course of oral prednisone, BCVA of the left eye improved from 20/200 to 20/50, but the patient could not tolerate the side effects, such as weight gain.[crimsonpublishers.com]
Hepatosplenomegaly
  • General examination revealed normal vital parameters with no evidence of any skin lesions, joint abnormalities, lymphadenopathy or hepatosplenomegaly.[docksci.com]
Pachyonychia
  • […] resources Hypopyon in anterior uveitis, seen as yellowish exudate in lower part of anterior chamber of eye ICD 10 H … Wikipedia List of diseases (P) — A list of diseases in the English Wikipedia.DiseasesTOC PaPac Pal* Pachydermoperiostosis * Pachygyria * Pachyonychia[medicine.academic.ru]
Blurred Vision
  • 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 include blurred vision, floaters, flashes, redness of the eye and eye pain.[monmouthretina.com]
  • This may lead to blurred vision; dark, floating spots in the vision; and progressive vision loss. As the condition advances, cataracts, retinal detachment, or macular edema (fluid within the retina) may develop.[xpertdox.com]
  • The most common presenting symptoms are floaters and blurred vision. Diffuse vitreous cells, haze, snowballs and snowbanks are typical findings of pars planitis. Peripheral retinal vasculitis, optic disc edema and… CONTINUE READING[semanticscholar.org]
Anterior Uveitis
  • Resources - Pars planitis Other names: Iritis; Uveitis ; Choroiditis; Chorioretinitis; Anterior uveitis; Posterior uveitis[checkorphan.org]
  • —Pars planitis is a form of anterior uveitis, the cause of which is not known.[jamanetwork.com]
  • Evidence of anterior uveitis is minimal - a few cells may occasionally be evident in the anterior chamber. Anterior and posterior synechiae are rare. Posterior subcapsular cataracts are frequent.[gpnotebook.co.uk]
  • Topical steroids are employed only if there is a concomitant anterior uveitis. Oral prednisone is more commonly used. However, once a commitment to use oral steroids is made, typically they must be used for months.[louisvillediabeticeyedoctor.com]
Visual Impairment
  • Conclusions: : Pars planitis in pediatric patients may cause significant visual impairment, and its presentation may vary considerably.[iovs.arvojournals.org]
  • Complications Decreased Visual Acuity Severe Visual Impairment : 35% Legally blind: 10% Iris scarring Impaired pupillary movement Secondary Glaucoma XIII.[fpnotebook.com]
Tremor
  • […] vision loss, pain on eye movement, double vision, oscillopsia, numbness or weakness in one or more limbs, tingling sensation or pain.The patient may also experience electric-shock sensations that occur with certain head movements (Lhermitte’s sign), tremor[digital.crojournal.com]
Lhermitte's Sign
  • ’s sign), tremor, lack of coordination, fatigue, dizziness and a visual heat intolerance (Uhtoff’s sign).[digital.crojournal.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]
  • 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]
Retinal Phlebitis
  • The remaining five eyes from four patients showed similar findings and included retinal phlebitis, disc and macular oedema, and the presence of a 'snowbank' over the inferior peripheral retina and pars plana.[ncbi.nlm.nih.gov]
  • phlebitis Pediatric Considerations In children, IU tends to cause greater anterior chamber inflammation DIAGNOSTIC TESTS & INTERPRETATION Lab • Complete blood count (CBC) with differential count • Erythrocyte sedimentation rate (ESR) • Purified protein[entokey.com]

Treatment

  • Three patients (five eyes) received scatter diode or argon photocoagulation treatment alone.[ncbi.nlm.nih.gov]

Prognosis

  • PURPOSE: To report the demographics and clinical characteristics, therapy logarithm, and prognosis of children with pars planitis.[ncbi.nlm.nih.gov]
  • 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

  • Although the etiology of pars planitis remains obscure, clinical evidence suggests a strong association with multiple sclerosis.[mayoclinic.pure.elsevier.com]
  • 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]
  • Multiple sclerosis is a chronic inflammatory demyelinating disease of the central nervous system that is presumed to be an autoimmune etiology.[aaopt.org]
  • 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]

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]
  • 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 İlknur Tuğal-Tutkun}, journal {Journal of ophthalmic & vision research}, year {[semanticscholar.org]
  • With the exception of age, no significantly statistical differences were observed when the visual prognosis and the clinical and epidemiologic characteristics were compared between the two groups of patients with and without associated MS; a diagnosis[tandfonline.com]
Sex distribution
Age distribution

Pathophysiology

  • • 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]
  • It is evident that genetics plays some role in the pathophysiology of intermediate uveitis, but the importance remains unclear.[wikidoc.org]
  • Pathophysiology The pathogenesis of pars planitis is not completely understood. Pars plana exudates are composed of a loose fibrovascular layer containing occasional fibrocyte-like cells and scattered mononuclear cells.[statpearls.com]

Prevention

  • Prevention - Pars planitis Treatment of an underlying disorder may help to prevent uveitis in persons with a body-wide (systemic) infection or disease. Diagnosis - Pars planitis 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]
  • 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]
  • 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]
  • […] blood vessels; choroid provides nutrients to the retina keeping it healthy Please find comprehensive information on Intermediate Uveitis regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention[dovemed.com]

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