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Phakic patients with cystoid macular edema, retinal periphlebitis, and vitreous inflammation
Journal article   Open access   Peer reviewed

Phakic patients with cystoid macular edema, retinal periphlebitis, and vitreous inflammation

D W Park, J C Folk, S M Whitcup, T D Polk, K Kansupada, C Fountain, J Brown and R B Nussenblatt
Archives of ophthalmology (1960), Vol.116(8), pp.1025-1029
08/1998
DOI: 10.1001/archopht.116.8.1025
PMID: 9715682
url
https://doi.org/10.1001/archopht.116.8.1025View
Published (Version of record) Open Access

Abstract

To characterize a group of phakic patients with idiopathic intermediate uveitis as defined by vitritis, cystoid macular edema, and retinal periphlebitis. Cross-sectional study. Nineteen phakic patients (35 eyes) with vitreous inflammation, cystoid macular edema, and/or retinal periphlebitis of unknown cause. None. Best-corrected final visual acuities, standardized clinical examinations, photographic and fluorescein angiographic evaluations, and class I and II HLA analysis on all 19 patients. Fifteen of the 19 patients were women. The mean age was 38 years, the mean follow-up was 104 months, and the mean duration of symptoms was 154 months. All 35 affected eyes had significant vitritis; 21 eyes (60%) had cystoid macular edema, 21 eyes (60%) had retinal periphlebitis. The median initial visual acuity was 20/30. The median final visual acuity was 20/20 with 32 (91%) of 35 eyes having 20/40 or better visual acuity at the final visit. No patient developed "snow-banks" or evidence of systemic disease, including multiple sclerosis or sarcoidosis, during the follow-up period. There were no statistically significant HLA associations in these patients compared with controls from another study from Iowa, but the Iowa phakic patients with cystoid macular edema did differ from the Iowa patients with pars-planitis at loci HLA-B8, HLA-B51, and HLA-DR2. We describe a disease entity of idiopathic intermediate uveitis that affects primarily young to middle-aged women and usually causes bilateral vitritis, cystoid macular edema, and retinal periphlebitis. Most patients retained good vision over a prolonged follow-up period. Multiple sequential examinations and HLA associations suggest that these conditions are distinct from other syndromes of intermediate uveitis, particularly parsplanitis.
Uveitis, Intermediate - blood Humans Macular Edema - pathology Middle Aged Retinal Diseases - blood Male Histocompatibility Antigens Class I - analysis Phlebitis - blood Macular Edema - etiology Retinal Diseases - etiology Retinal Diseases - pathology Adult Female Phlebitis - pathology Phlebitis - etiology Child Eye Diseases - pathology Fluorescein Angiography Retinal Vein - pathology Cross-Sectional Studies Eye Diseases - etiology Uveitis, Intermediate - pathology Uveitis, Intermediate - complications Histocompatibility Antigens Class II - analysis Visual Acuity Macular Edema - blood Adolescent Eye Diseases - blood Vitreous Body - pathology Aged

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