2 peripheral scatter photocoagulation for neovascularization associated with pars planitis

S. E. Park, W. F. Mieler and J. S. Pulido
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA.

BACKGROUND: Peripheral cryotherapy appears to be efficacious in the treatment of neovascularization of the vitreous base in patients with pars planitis, although it may be associated with the development of rhegmatogenous retinal detachments. OBJECTIVE: To evaluate the safety and efficacy of peripheral scatter photocoagulation for treatment of neovascularization of the vitreous base when used alone or combined with pars plana vitrectomy. METHODS: Six patients (10 eyes) presented with vitritis, cystoid macular edema, and neovascularization of the vitreous base, unresponsive to corticosteroid therapy. Three patients (five eyes) received scatter diode or argon photocoagulation treatment alone. The other three patients (five eyes) underwent pars plana vitrectomy coupled with argon or diode photocoagulation, placed in three rows, posterior to the area of inferior neovascularization of the vitreous base. RESULTS: Pretreatment visual acuity ranged from 20/20 to 20/200. All patients were followed up for a minimum of 6 months. After placement of photocoagulation (with or without concurrent pars plana vitrectomy), the neovascularization regressed, inflammation was stabilized, and cystoid macular edema improved in all eyes. There were no retinal detachments or other complications of treatment. Posttreatment visual acuity ranged from 20/20 to 20/100. When final visual acuity was 20/40 or less, cataract formation was generally responsible. CONCLUSIONS: Peripheral scatter photocoagulation is efficacious and appears at least equal to peripheral cryotherapy in causing regression of neovascularization of the vitreous base in patients with pars planitis.