Our Summary

This study looked at the use of a specific diagnostic procedure called pars plana vitrectomy (PPV) in cases of uveitis, a type of eye inflammation, where the cause is initially unknown. The researchers reviewed 16 studies involving 1,195 patients up until October 2017.

They found that the PPV was successful in identifying the cause of the uveitis in 44% of cases. Of these, 69% were diagnosed with an infection, 23% had lymphoma (a type of cancer), and 4% had metastatic carcinoma (another type of cancer). The most common infections found were viruses, bacteria, and various parasites.

The researchers also looked at potential complications from the PPV procedure. They found a 19% chance of developing a cataract and a 5% chance of retinal detachment after the procedure. In addition, 10% of patients needed a second vitrectomy surgery.

However, almost half of the patients (46%) saw an improvement in their vision after the procedure. In 20% of cases, the results of the PPV led to a change in the patient’s treatment plan.

In conclusion, the researchers believe that PPV is a reliable and relatively safe diagnostic procedure for uveitis of unknown cause. It can help doctors establish a definite diagnosis and guide further treatment. It can also have a positive effect on the patient’s vision.

FAQs

  1. What is the success rate of the pars plana vitrectomy (PPV) in identifying the cause of uveitis?
  2. What are the potential complications from the PPV procedure?
  3. How often did the results of the PPV lead to a change in the patient’s treatment plan?

Doctor’s Tip

A doctor may advise a patient undergoing vitrectomy to be aware of potential complications such as developing a cataract or retinal detachment. They may also discuss the possibility of needing a second surgery and the importance of following post-operative care instructions to ensure the best possible outcome. Additionally, they may emphasize the potential benefits of the procedure, such as improving vision and guiding treatment decisions.

Suitable For

Patients who may be recommended vitrectomy include those with uveitis of unknown cause, particularly those suspected to have an infection, lymphoma, or metastatic carcinoma. Other potential candidates for vitrectomy may include patients with retinal detachment, macular hole, diabetic retinopathy, or other retinal conditions that require surgical intervention. Ultimately, the decision to undergo vitrectomy will depend on the specific condition and individual circumstances of each patient, and should be discussed with a qualified ophthalmologist.

Timeline

Timeline:

Before vitrectomy:

  1. Patient experiences symptoms of uveitis, such as eye pain, redness, and vision changes.
  2. Patient undergoes a comprehensive eye examination, including imaging tests and blood work, to determine the cause of the uveitis.
  3. If the cause of the uveitis remains unknown, the patient may be recommended to undergo a pars plana vitrectomy (PPV) procedure.

After vitrectomy:

  1. Patient undergoes the PPV procedure, during which a small incision is made in the eye to remove the vitreous gel and examine it for potential causes of uveitis.
  2. In 44% of cases, the PPV successfully identifies the cause of the uveitis, such as infection, lymphoma, or metastatic carcinoma.
  3. Potential complications post-PPV include the development of a cataract (19% chance), retinal detachment (5% chance), and the need for a second vitrectomy surgery (10% of patients).
  4. 46% of patients experience an improvement in their vision after the procedure, and 20% see a change in their treatment plan based on the results of the PPV.
  5. Overall, the researchers conclude that PPV is a reliable and relatively safe diagnostic procedure for uveitis of unknown cause, with the potential to improve vision and guide further treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vitrectomy?
  2. How successful is vitrectomy in identifying the cause of uveitis in cases where the cause is unknown?
  3. What are the chances of developing a cataract or retinal detachment after vitrectomy?
  4. How likely is it that I will need a second vitrectomy surgery?
  5. How soon after the procedure can I expect to see improvements in my vision?
  6. Will the results of the vitrectomy procedure change my treatment plan?
  7. Are there any alternative diagnostic procedures or treatments that I should consider?
  8. How experienced are you in performing vitrectomy procedures for uveitis cases?
  9. What is the recovery process like after vitrectomy surgery?
  10. Are there any specific lifestyle changes or precautions I should take post-surgery to ensure a successful outcome?

Reference

Authors: Zhao XY, Xia S, Chen YX. Journal: Retina. 2020 Feb;40(2):359-369. doi: 10.1097/IAE.0000000000002372. PMID: 31972807