Clinical and imaging features of sympathetic ophthalmia and efficacy of the current therapy

Abstract

Purpose The purpose of the study was to clarify the clinical and imaging features of sympathetic ophthalmia (SO) and evaluate the efficacy of the current therapy. Methods The databases PubMed, EMBASE and Ovid up to January 2021 were searched to identify relevant studies. R software version 3.6.3 was used to perform the statistical analyses. Results Thirty‐two studies involving 1067 patients were finally included. Our study found SO was male‐dominated, and more than half of SO patients aged 16 to 60 years old. Ocular trauma, surgical interventions and unknown events were estimated to be inciting events in 63%, 36% and 4% of SO patients. About 35% of the patients underwent baseline enucleation, and 45% took compelled enucleation during follow‐up. The most common symptoms at the first presentation were decreased vision, followed by pain and redness. The most common signs were anterior chamber cells/flare, followed by vitritis, exudative retinal detachment and Dalen–Fuch nodules. Choroidal thickening was detected in 81% of SO patients by ocular ultrasound. The most common fluorescein fundus angiography signs were disc leakage. After corticosteroid therapy became the mainstay for SO, about 76% of SO patients could get inflammation well‐controlled, while 24% of them might have recurrent inflammation. Around 72% of SO patients could achieve visual improvement, and more than half of them might have a best‐corrected visual acuity of 20/50 or better. Conclusion SO is a complicated ocular disease with diverse clinical manifestations and imaging features. After proper anti‐inflammation therapy, SO might not necessarily result in a poor prognosis.

Mild-to-Moderate Traumatic Brain Injury: A Review with Focus on the Visual System

“…Surgery on patients with no light perception often ends in enucleation, or the complete removal of the eye, to prevent sympathetic ophthalmia, a sight-threatening disorder caused by trauma to the contralateral eye [150]. However, surgical globe repair may be a preferred alternative [151][152][153].…”