Department of Ophthalmology, New York Medical College, USA
*Corresponding author: Department of Ophthalmology, New York Medical College, USA
Submission: October 26, 2017; Published: May 03, 2018
ISSN: 2578-0360 Volume2 Issue1
Importance: Pars planitis is a disease that occurs in healthy young adults or children that commonly leads to significant visual loss. Although pars planitis is a diagnosis of exclusion, there is a lack of agreement in the literature pertaining to the clinical findings observed in patients with pars planitis. Corneal haze was not described before in this context and its presence may help with early diagnosis of pars planitis.
Objective: The primary objective of this study was to assess the presence of corneal haze in patients with pars planitis, especially in the absence of Keratic precipitate (KP).
Design: Case series study included six patients with an established diagnosis of pars planitis that were seen by the Uveitis Service between 2009 and 2011. Setting: New York Medical College
Participants: Six patients with pars planitis that were examined between 2009 and 2011.
Main Outcomes and Measures: Main outcome measures include findings observed on slit lamp examination, such as anterior chamber inflammation, KP, corneal haze, vitritis, vasculitis, and cystoid macular edema (CME).
Results: All six patients demonstrated anterior chamber inflammation, vitritis, and corneal haze without KP except for one patient. Retinal vasculitis was appreciated in two patients on clinical fundus examination and confirmed by fluorescein angiography. Cystoid Macular edema (CME) was appreciated in three patients, and confirmed using Optical coherence tomography (OCT).
Conclusions and Relevance: In previous case reports, corneal haze was found in the inferior cornea zone with the presence of KP along the junction between affected and unaffected cornea. As most of our patients (five out of six patients) demonstrate corneal haze in the absence of KP, we concluded that the presence of KPs is not a key factor in the pathophysiology of inferior corneal haze development, and the condition remains permanent even after good control of inflammation. Because of this, different theories may be used to explain the presence of corneal haze in pars planitis.
Abbreviations: KP: Keratic precipitate; CME: Cystoid Macular Edema; OCT: Optical Coherence Tomography; IU: Intermediate Uveitis; SUN: Standardization of Uveitis Nomenclature; MTX: Methotrexate
Key Points a. The primary objective was to determine the slit lamp examination findings associated with pars planitis to aid in its diagnosis. b. In this case series, all six patients with an established diagnosis of pars planitis demonstrated anterior chamber inflammation, vitritis, and corneal haze. Corneal involvement was without presence of Keratic precipitate, except for one patient. c. Corneal haze, with or without Keratic precipitate, is a new finding that can be used to help other ophthalmologists in the diagnosis of pars planitis.