97th DOG Annual Meeting 1999



B. Wiechens, B. Nölle, J. Reichelt

Background: Cystoid macular edema (CME) is a common complication in the course of intermediate uveitis (Pars Planitis). In spite of systemic therapy with steroids or carboanhydrase inhibitors persistence of CME is observed. Pars-plana-vitrectomy (PPV) is known to influence the course of intermediate uveitis positively. The present study was performed to investigate the role of PPV in the therapy of CME in intermediate uveitis.

Patients und methods: 37 eye of 28 patients were re-examined after PPV for CME. In all eyes fluorescein angiography was performed. Average age at the time of surgery was 34.3 years (range: 5-64 years). All patients had received systemic corticosteroid treatment during the course of their disease. In some of these patients systemic therapy with carboanhydrase inhibitors was performed. Average postoperative follow-up was 16 months (6-102 months).

Results: Preoperative visual acuity (V.A.) in all eyes was between 1/10 und 20/40. Regression of CME after surgery was observed in 19 out of 37 eyes. In 18 out of 37 eyes the CME remained unchanged. 17 out of 37 eyes experienced a postoperative improvement of V.A. of more than 2 lines. In 16 out of 37 eyes there was no change compared to preoperative V.A., in 4 out of 37 eyes V.A. was worse.

Conclusion: Pars-plana-vitrectomy can lead to regression of CME and subsequent improvement of visual acuity in about 50% of eyes with CME in intermediate uveitis. In those cases refractory to medical therapy PPV should be considered.

Section of Vitreoretinal Surgery Dept. of Ophthalmology, Christian-Albrechts-University, Hegewischstr. 2, D - 24105 Kiel