Purpose: Despite patients receiving pharmacotherapy, intraocular inflammatory disease sometimes causes prolonged macular edema, epimacular membrane formation, and vitreous opacity, resulting in reduced visual acuity. Surgical treatments such as vitrectomy can be chosen to resolve these symptoms in such patients. The present study investigated the postoperative clinical course of intraocular inflammatory disease in patients exhibiting no improvement in their clinical symptoms despite pharmacotherapy.
Method: This study evaluated 45 eyes of patients with sarcoidosis, 14 of those with intraocular lymphomas, 11 of those with infectious endophthalmitis, and 16 of those with idiopathic intraocular inflammatory disease. Visual acuity and central macular thickness were evaluated in all patients preoperatively and 1 and 3 months following the initial vitrectomy.
Results: Whole case analysis indicated significant improvement in the visual acuity after the surgery (p<0.001). Significant improvement in the visual acuity was particularly noted in patients with sarcoidosis and lymphoma after the operation (p<0.05). However, there was no significant improvement in the visual acuity in patients with endophthalmitis and idiopathic intraocular inflammatory disease. Furthermore, no significant differences were observed in central macular thickness between befor and after the surgery in any disease groups.
Conclusions: Our results demonstrated that surgical treatments improved visual acuity in ocular inflammatory disease, particularly in patients with sarcoidosis and lymphoma who did not respond to pharmacotherapy; this is consistent with many previous reports. Thus, surgical procedures may be a viable treatment option for intraocular inflammatory disease that does not respond to pharmacotherapy.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 393-399, 2018.