■ Pars plana exudates in intermediate uveitis (IU) are associated with more severe vitreous disease and increased incidence
of cystoid macular edema (CME).
■ Cryotherapy and laser photocoagulation are used in the treatment of the pars planitis variant of corticosteroid resistant
IU.
■ Cryotherapy should be avoided in retinal detachment or marked peripheral vitreoretinal adhesions. A B-scan ultrasound may
be needed.
■ Technique for cryotherapy:
- Peribulbar or sub-Tenon anesthesia.
- “Freeze-thaw-freeze” or “double row single freeze” of inferior snowbank.
- Treat contiguous, uninvolved retina (one third width of snowbank) and area with dense exudates.
- Average of 20 freezes per eye.
- Postoperative posterior sub-Tenon injection of long-acting corticosteroids and topical steroids.
■ Technique for laser photocoagulation:
- Topical anesthesia is preferred for office treatment.
- Endophotocoagulation may be performed during pars plana posterior vitrectomy, under peribulbar, retrobulbar or general anesthesia.
- Nonconfluent, grayish laser marks, 300–500-μm wide, 0.2 s duration.