Novel Optical Coherence Tomography Findings of a Case of Sympathetic Ophthalmia After 23-Gauge Vitrectomy

Abstract

Purpose: Sympathetic ophthalmia (SO) is a rare panuveitis after trauma to one eye. We present a case of SO after 23-gauge transconjunctival vitrectomy, including optical coherence tomography evidence of response to treatment. To our knowledge, this is the first SO case report to include spectral domain optical coherence tomography images of Dalen-Fuchs nodules.Methods: Observational case report of a case of SO after two pars plana vitrectomies in the fellow eye.Results: A 67-year-old woman who had an operation for her pseudophakic left eye for a macula-off retinal detachment. She had two surgeries and later on had a total retinal detachment with vision of no perception of light. Eighteen months later, she presented back with a panuveitis with vitritis in her other eye and a visual acuity of 6/18. Dalen-Fuchs denoting SO was found. Treatment was commenced, and multimodal imaging was performed.Conclusion: Sympathetic ophthalmia is a known complication after vitrectomy. Optical coherence tomography can be invaluable in monitoring diagnosis and progression of Dalen-Fuchs nodules.

Sympathetic ophthalmia after vitreoretinal surgery: a report of two cases

“… 15 Dalen–Fuchs nodules are semicircular nodules that are mainly composed of epithelioid cells and lymphocytes within the choroid. These nodules are present in one-third of SO patients; 16 , 17 however, we did not observe these nodules in our cases. This may be because our intervention was early and had preceded the development of granulomatous uveitis, or because the follow-up time was insufficient.…”

Sympathetic ophthalmia: Report of a case series and comprehensive review of the literature

“…We described 16 new SO patients at our hospital then conducted a literature search, retrieving a total of 87 previous case reports of SO. 9,10,16–67 These 103 patients had an average age at presentation of 44.9 years (ranging from 2.5–85 years) and consisted of 69 males (66.9%) and 34 females (33.1%). There were 51 patients (49.5%) who underwent ocular therapies and 52 patients (50.5%) with a previous history of trauma.…”