Pediatric Pars Planitis: A Review

Ocul Immunol Inflamm. 2023 Dec;31(10):1915-1929. doi: 10.1080/09273948.2023.2279683. Epub 2023 Dec 14.

Abstract

Purpose: To provide an overview of pediatric pars planitis.

Methods: Narrative literature review.

Results: Pars planitis refers to the idiopathic subset of intermediate uveitis in which there is vitritis along with snowball or snowbank formation occurring in the absence of an associated infection or systemic disease. It is thought to be a T-cell mediated disease with a genetic predisposition. Pars planitis accounts for 5-26.7% of pediatric uveitis cases. Presentation is commonly bilateral but asymmetric, often with insidious onset of floaters and blurred vision. Although pars planitis is known to be a benign form of uveitis in most cases, severe complications secondary to chronic inflammation may arise, with cystoid macular edema being the most common cause of visual morbidity. Mild vitritis in the absence of symptoms, vision loss, or macular edema may be observed. Patients with severe vitritis and/or associated vision-threatening complications require prompt aggressive treatment. A stepladder approach including corticosteroids, immunosuppressive agents, anti‑tumor necrosis factor‑alpha and pars plana vitrectomy and/or laser photocoagulation is the most commonly used method for treatment of pars planitis.

Conclusion: Timely diagnosis and adequate treatment of pediatric pars planitis and associated complications are crucial in order to improve visual outcomes.

Keywords: Intermediate uveitis; macular edema; pars planitis; pediatric uveitis; snowballs.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones
  • Child
  • Endophthalmitis* / surgery
  • Humans
  • Macular Edema* / diagnosis
  • Macular Edema* / etiology
  • Macular Edema* / therapy
  • Pars Planitis* / diagnosis
  • Pars Planitis* / epidemiology
  • Pars Planitis* / therapy
  • Retrospective Studies
  • Uveitis* / complications
  • Uveitis, Intermediate* / complications
  • Vitrectomy

Substances

  • Adrenal Cortex Hormones