Sympathetic Ophthalmia: Incidence of Ocular Complications and Vision Loss in the Sympathizing Eye

Davis, Janet L.; Flynn, Harry W.; Feuer, William J.; Dubovy, Sander R.; Setlur, Vikram; Kesen, Muge R.; Goldstein, Debra A.; Tessler, Howard H.; Jabs, Douglas A.; Thorne, Jennifer E.

doi:10.1016/j.ajo.2009.05.033

Cited by 75 publications

(61 citation statements)

References 15 publications

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“…Only one patient showed the presence of cystoid changes at 4 weeks when the disease recurred. In a recently published study [13], the presence of an exudative retinal detachment and active intraocular inflammation was found to correlate with poorer vision in the sympathizing eye, thus indicating that the photoreceptors may have suffered irreversible damage due to long-standing retinal detachment.…”

Section: Discussionmentioning

confidence: 96%

Reversible retinal changes in the acute stage of sympathetic ophthalmia seen on spectral domain optical coherence tomography

Gupta

Dogra

et al. 2011

Int Ophthalmol

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To report the changes seen in the photoreceptor layer during the acute phase of sympathetic ophthalmia. Six consecutive patients diagnosed with sympathetic ophthalmia were enrolled in the study. All 6 patients had a fundus fluorescein angiogram and spectral domain optical coherence tomography (OCT) scan carried out at presentation. The outer retinal segment was demarcated on the raster line scan between the external limiting membrane (ELM) and the retinal pigment epithelium (RPE)-choriocapillaris complex. All patients received intravenous methylprednisolone followed by oral corticosteroids 1-1.5 mg/kg/day. The serial follow-up OCT scans taken 48 h after the initiation of treatment, and 1, 2 and 12 weeks later, were studied and compared. The retina inner to the ELM did not show any remarkable structural alteration in any of the eyes. The outer retinal segment demarcated by the ELM and the RPE-choriocapillaris complex showed serous retinal detachment in all the eyes and elongation of photoreceptors could be seen in four eyes. There was a disruption to the continuity of the two inner hyper-reflective bands in all the eyes. A repeat raster line scan performed 48 h after systemic corticosteroid therapy showed a reduction in the height of the serous retinal detachment with elongation of photoreceptors and the protrusion of their apical segments into the serous detachment in 4 eyes. The serous detachment showed a progressive reduction in height following intravenous methyprednisolone therapy in all the eyes over the following week with elongated photoreceptors in all six eyes. After two weeks, none of the eyes showed any residual detachment and this corresponded with the improvement in visual acuity in all the eyes. OCT raster line scans repeated at 4 weeks showed resolution of serous detachment with normal photoreceptor layer and restoration of a third hyper-reflective band (IS/OS junction) in all the eyes. The photoreceptor layer is involved during the acute phase of sympathetic ophthalmia as indicated by the in vivo morphological changes seen on spectral domain OCT. These changes are reversible following systemic corticosteroid therapy thus supporting the hypothesis that prompt and aggressive anti-inflammatory therapy is capable of reversing the photoreceptor changes.

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Section: Discussionmentioning

confidence: 96%

Reversible retinal changes in the acute stage of sympathetic ophthalmia seen on spectral domain optical coherence tomography

Gupta

Dogra

et al. 2011

Int Ophthalmol

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“…Interestingly, in a large cohort of SO patients, female sex was the only factor significantly associated with incident vision loss. 114 There are no reports indicating that men are more likely than women to develop SO once trauma is encountered. In fact, recent reports indicate that both sexes are affected equally.…”

Section: Non-infectous Uveitidesmentioning

confidence: 99%

Gender Disparities in Ocular Inflammatory Disorders*

Sen

Davis

Uçar

et al. 2014

Current Eye Research

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Ocular inflammatory disorders disproportionately affect women, and the majority of affected women are of childbearing age. The role of sex or reproductive hormones has been proposed in many other inflammatory or autoimmune disorders, and findings from non-ocular autoimmune diseases suggest a complex interaction between sex hormones, genetic factors and the immune system. However, despite the age and sex bias, factors that influence this disparity are complicated and unclear. This review aims to evaluate the gender disparities in prevalence, incidence and severity of the most common infectious and non-infectious ocular inflammatory disorders.

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“…Galor et al reviewed 85 patients with SO and showed a slight male predilection of male gender (60%) with a higher incidence of traumatic etiology (62%) [73]. We reviewed 32 patients with SO presented at the National Eye Institute, including 23 patients with SO resulting from trauma and 9 resulting from surgery.…”

Section: Gender and Somentioning

confidence: 99%

Gender Differences in Vogt-Koyanagi-Harada Disease and Sympathetic Ophthalmia

Wang

Chan

2014

Journal of Ophthalmology

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Vogt-Koyanagi-Harada disease (VKH) and sympathetic ophthalmia (SO) are types of T-cell mediated autoimmune granulomatous uveitis. Although the two diseases share common clinical features, they have certain differences in gender predilections. VKH classically has been reported as more prevalent in females than males, yet some studies in Japan and China have not found differences in gender prevalence. Male patients have a higher risk of chorioretinal degeneration, vitiligo, and worse prognosis. Conversely, the changing levels of estrogen/progesterone during pregnancy and the menstrual cycle as well as higher levels of TGF-β show a protective role in females. Potential causes of female predilection for VKH are associated with HLA-DR and HLA-DQ alleles. SO, a bilateral granulomatous uveitis, occurs in the context of one eye after a penetrating injury due to trauma or surgery. In contrast to the female dominance in VKH, males are more frequently affected by SO due to a higher incidence of ocular injury, especially during wartime. However, no gender predilection of SO has been reported in postsurgical cases. No clinically different manifestations are revealed between males and females in SO secondary to either ocular trauma or surgery. The potential causes of the gender difference may provide hints on future treatment and disease evaluation.

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Sympathetic Ophthalmia: Incidence of Ocular Complications and Vision Loss in the Sympathizing Eye

Cited by 75 publications

References 15 publications

Reversible retinal changes in the acute stage of sympathetic ophthalmia seen on spectral domain optical coherence tomography

Reversible retinal changes in the acute stage of sympathetic ophthalmia seen on spectral domain optical coherence tomography

Gender Disparities in Ocular Inflammatory Disorders*

Gender Differences in Vogt-Koyanagi-Harada Disease and Sympathetic Ophthalmia

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