Comparison of Clinical Features and Visual Outcome between Sympathetic Ophthalmia and Vogt–Koyanagi–Harada Disease in Chinese Patients

Yang, Peizeng; Liu, Shulin; Zhong, Zhenyu; Du, Liping; Ye, Zi; Zhou, Wenjun; Kijlstra, Aize

doi:10.1016/j.ophtha.2019.03.049

Cited by 36 publications

(30 citation statements)

References 18 publications

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“…Visual outcome is worse in SO as compared with VKH disease 8 . However, Vision was improved in our case because of early diagnosis and prompt aggressive and adequate treatment as it can be observed on ICGA was taken 3 months after treatment.…”

Section: Discussionmentioning

confidence: 86%

“…It is well known that SO and VKH are common uveitis etiologies with similar clinical and imaging ndings in Asian. Although sympathizing eye in SO presents initially with nongranulomatous uveitis clinically and then progresses to granulomatous uveitis 8 . VKH shows 3 successive stages: posterior uveitis, anterior segment involvement associated with posterior uveitis, and nally anterior granulomatous uveitis.SO has variable presentations.…”

Section: Discussionmentioning

confidence: 99%

“…In 75% of cases presented with anterior chamber reaction 6 . Anterior uveitis and posterior uveitis both are present in SO patients seen within 2 weeks of disease onset 8 . In our case clinical features are more similar to SO than VKH, in the other hand our case had not any systemic sign or symptoms attributed to VKH or other systemic diseases causing choroiditis.…”

Section: Discussionmentioning

confidence: 99%

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Presumed Sympathetic Ophthalmia After Scleral Buckling Surgery: Case Report

Hosseini

Shoeibi

Zadeh

et al. 2020

Preprint

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Background: We aimed to report a rare case of presumed sympathetic ophthalmia (SO) in a young female patient following scleral buckling (SB). As SB is usually considered an extraocular operation, it is presumed to have low risk of SO.Case Presentation: A nineteen year-old female patient was referred for visual loss in her left eye because of macula off inferior longstanding rhegmatogenous retinal detachment (RD). Best corrected visual acuity (BCVA) was 20/400 in the left eye. SB with 360 degrees encircling band and inferior segmental tire, with one spot cryoretinopexy at the break site and subretinal fluid drainage was performed. One week after operation, visual acuity was improved to 20/80 and retina was totally attached. Six weeks later, patient came with severe visual loss in both eyes as counting finger 1 meter. Bilateral multifocal serous RD and vitreous cells was found. The patient was treated with intravenous corticosteroid pulse therapy and mycpphenolate mofetile as a case of sympathetic ophthalmia. The inflammation was controlled and serous RD resolved after five days intravenous treatment and was not relapsed after six months. BCVA was 20/20 in right eye and 20/50 in the left eye. Systemic workup was negative for any extraocular disease or systemic involvement.Conclusion: As SB usually considered as a procedure without manipulating intraocular tissues, it is considered to have low risk for SO. In this report, we have shown that SO may occur after successful SB. Inciting the choroid and retinal pigment epithelium with cryoretinopexy or perforating for drainage may induce SO.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Presumed Sympathetic Ophthalmia After Scleral Buckling Surgery: Case Report

Hosseini

Shoeibi

Zadeh

et al. 2020

Preprint

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“…2). Begleitend ist häufig eine intraokulare Drucksteigerung [12]. Überwiegend liegt eine mäßige bis ausgeprägte Glaskörpertrübung (Vitreous Haze 1+ -4+) vor.…”

Section: Klinikunclassified

“…Trotz steigender Operationszahlen in den letzten Jahrzehnten ist das Augentrauma nach wie vor die Hauptursache einer SO, vermutlich durch die Entwicklung zeitgleich minimalinvasiver, weniger traumatischer Operationsverfahren (▶ Tab. 1) [4][5][6][7][8][9][10][11][12][13]. Sie reichen (mit steigender Prävalenz) von einer transskleralen Ziliarkörperdestruktion und Brachytherapie beim uvealen Melanom über minimalinvasive intraokulare Eingriffe wie einer Parazentese bis zu Glaskörper-/Retinaeingriffen.…”

Section: Introductionunclassified

Sympathetic Ophthalmia – a Contribution to Immunology, Clinic and Current Imaging

Rua

Pohlmann

Pleyer

2020

Klin Monbl Augenheilkd

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Background Sympathetic ophthalmia (SO) is a rare inflammation of an operated or injured eye that spreads to the fellow eye. It is typically a bilateral granulomatous panuveitis. The traumatized eye is referred to as inciting eye and the fellow eye as sympathizing eye. The pathophysiology of the disease is not entirely understood, but there is strong evidence of an autoimmune genesis. Patients/Material and Methods A selective literature search on epidemiology, immunology, clinical features and risk factors of SO was carried out. In addition, our own experience using multimodal imaging for this clinical entity was introduced. Results In the literature, the incidence after traumatic eye injuries is 0.1 – 3% and approximately 0.01% after intraocular surgery. Among the iatrogenic causes, vitreoretinal surgery has the highest rate of SO, presumably due to disruption of the blood-retinal barrier and involvement of retinal and choroidal tissue, which are susceptible to anterior traction, phthisis and chronic inflammation. In 90% of patients, the disease develops within a year following the eliciting event and is associated with a potentially bilateral risk of blindness. Typical symptoms include bilateral visual impairment with photophobia, dull pain and photopsia. The spectrum of clinical manifestations ranges from granulomatous anterior uveitis and vitritis, to choroiditis, serous retinal detachment and Dalen-Fuchs nodules in the context of posterior involvement. The diagnosis of SO is generally based on clinical presentation and is supported by imaging methods. These primarily comprise fluorescein and indocyanine green angiography, which are increasingly being supplemented by non-invasive methods such as optical coherence tomography. They can provide important information for assessment of severity, differential diagnosis as well as for disease monitoring. The differential diagnosis includes i. a. Vogt-Koyanagi-Harada syndrome, ocular sarcoidosis and the rare phacoanaphylactic endophthalmitis. Immediate systemic high-dose steroid therapy is used as initial treatment. The course of the disease is often relapsing to chronic progressive. Immunomodulators such as ciclosporine A, azathioprine, cyclophosphamide, mycophenolate mofetil, and biologics are increasingly being used and contribute to the significantly better prognosis of the disease. Generally, SO can be triggered by any kind of intraocular intervention. Conclusion SO remains a threatening clinical diagnosis that poses diagnostic and therapeutic challenges. It can be triggered post-traumatic, but also any intraocular surgery. This should be taken into account when assessing the indication for intraocular eye surgery, especially in eyes with reduced visual outcome.

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Autoimmune uveitis in Behçet's disease and Vogt‐Koyanagi‐Harada disease differ in tissue immune infiltration and T cell clonality

Kang,

Sun,

Yang

et al. 2023

Clin & Trans Imm

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ObjectivesNon‐infectious uveitis is often secondary to systemic autoimmune diseases, with Behçet's disease (BD) and Vogt‐Koyanagi‐Harada disease (VKHD) as the two most common causes. Uveitis in BD and VKHD can show similar clinical manifestations, but the underlying immunopathogenesis remains unclear.MethodsTo understand immune landscapes in inflammatory eye tissues, we performed single‐cell RNA paired with T cell receptor (TCR) sequencing of immune cell infiltrates in aqueous humour from six patients with BD (N = 3) and VKHD (N = 3) uveitis patients.ResultsAlthough T cells strongly infiltrated in both types of autoimmune uveitis, myeloid cells only significantly presented in BD uveitis but not in VKHD uveitis. Conversely, VKHD uveitis but not BD uveitis showed an overwhelming dominance by CD4+ T cells (> 80%) within the T cell population due to expansion of CD4+ T cell clusters with effector memory (Tem) phenotypes. Correspondingly, VKHD uveitis demonstrated a selective expansion of CD4+ T cell clones which were enriched in pro‐inflammatory Granzyme H+ CD4+ Tem cluster and showed TCR and Th1 pathway activation. In contrast, BD uveitis showed a preferential expansion of CD8+ T cell clones in pro‐inflammatory Granzyme H+ CD8+ Tem cluster, and pathway activation for cytoskeleton remodelling, cellular adhesion and cytotoxicity.ConclusionSingle‐cell analyses of ocular tissues reveal distinct landscapes of immune cell infiltration and T‐cell clonal expansions between VKHD and BD uveitis. Preferential involvements of pro‐inflammatory CD4+ Th1 cells in VKHD and cytotoxic CD8+ T cells in BD suggest a difference in disease immunopathogenesis and can guide precision disease management.

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Comparison of Clinical Features and Visual Outcome between Sympathetic Ophthalmia and Vogt–Koyanagi–Harada Disease in Chinese Patients

Cited by 36 publications

References 18 publications

Presumed Sympathetic Ophthalmia After Scleral Buckling Surgery: Case Report

Presumed Sympathetic Ophthalmia After Scleral Buckling Surgery: Case Report

Sympathetic Ophthalmia – a Contribution to Immunology, Clinic and Current Imaging

Autoimmune uveitis in Behçet's disease and Vogt‐Koyanagi‐Harada disease differ in tissue immune infiltration and T cell clonality

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