The Risk of Sympathetic Ophthalmia after Vitreoretinal Surgery

Anikina, Evgenia; Wagner, Siegfried; Liyanage, Sidath; Sullivan, Paul; Pavésio, Carlos; Okhravi, Narciss

doi:10.1016/j.oret.2022.01.012

Cited by 12 publications

(21 citation statements)

References 20 publications

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“…After the title and abstract screening, we excluded 188 studies, and only 20 full-text studies were retrieved and assessed for final eligibility. Furthermore, an additional 5 articles were excluded because SO was neither triggered by VR surgery procedures in eyes without an antecedent history of trauma nor epidemiologic SO rates after VR surgery were investigated, resulting in 15 studies included in the systematic review [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among the 15 studies included in the qualitative analysis, all [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ] except two studies [ 11 , 16 ] reported the exact number of SO over a specific period. Indeed, these studies reported only SO’s clinical presentation, course, and outcomes following vitreoretinal surgeries.…”

Section: Resultsmentioning

confidence: 99%

“…Several surgical procedures have been reported as the primary triggers of SO, including cyclo-destructive procedures, cataract surgery, glaucoma filtration surgery, evisceration, and retinal laser photocoagulation [ 5 ]. Since the 1980s, the association between vitreoretinal (VR) surgery and SO has been investigated, and in recent years, ocular surgery, especially vitrectomy, has become an increasingly prevalent risk factor for SO [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. However, most of these studies are heterogeneous, and they did not highlight well whether VR surgery alone or in combination with other surgical procedures in eyes with or without a history of previous ocular surgery or trauma represented the inciting event causing SO.…”

Section: Introductionmentioning

confidence: 99%

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Sympathetic Ophthalmia after Vitreoretinal Surgery without Antecedent History of Trauma: A Systematic Review and Meta-Analysis

Ripa

Panos

Ręjdak

et al. 2023

JCM

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Background: To evaluate the morbidity frequency measures in terms of the cumulative incidence of sympathetic ophthalmia (SO) triggered by single or multiple vitreoretinal (VR) surgery procedures in eyes without an antecedent history of trauma and previous ocular surgery, except for previous or concomitant uneventful lens extraction, and to further investigate the relationship between VR surgery and SO. Methods: A literature search was conducted using PubMed, Embase, and Scopus from inception until 11 November 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist for the case series and the Newcastle–Ottawa Scale were used to assess the risk of bias. The research was registered with the PROSPERO database (identifier, CRD42023397792). Meta-analyses were conducted using the measurement of risk and a 95% confidence interval (CI) for each study. Results: A random-effect meta-analysis demonstrated that the pooled cumulative incidence of SO triggered by single or multiple VR surgery procedures in eyes without an antecedent history of trauma and previous ocular surgery, except for previous or concomitant uneventful lens extraction among patients who developed SO regardless of the main trigger, was equal to 0.14 with a CI between 0.08 and 0.21 (I2 = 78.25, z: 7.24, p < 0.01). The pooled cumulative incidence of SO triggered by single or multiple VR surgery procedures in eyes without an antecedent history of trauma and previous ocular surgery, except for previous or concomitant uneventful lens extraction among patients who underwent VR surgery, was equal to 0.03 for every 100 people, with a confidence interval (CI) between 0.02% and 0.004% (I2 = 27.77, z: 9.11, p = 0.25). Conclusions: Despite postsurgical SO being a rare entity, it is a sight-threatening disease. VR surgery should be viewed as a possible inciting event for SO and considered when counseling patients undergoing VR surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sympathetic Ophthalmia after Vitreoretinal Surgery without Antecedent History of Trauma: A Systematic Review and Meta-Analysis

Ripa

Panos

Ręjdak

et al. 2023

JCM

View full text Add to dashboard Cite

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“…There has been an increase in the importance of intraocular surgeries as the first inciting event for SO, and surgical procedures, including vitreoretinal surgeries, also accounted for more than 90% of the last event before SO diagnosis ( 4 ). Nonetheless, there has been no reported way to evaluate that in whom inflammation has been started by an inciting event but still without typical manifestations of SO.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, multiple surgical interventions have been regarded as important in SO (2). In a recent study, the risk of developing SO rose exponentially with the number of vitreoretinal surgeries, 10.3389/fmed.2023.1118913 Frontiers in Medicine 02 frontiersin.org although it was low after a single vitreoretinal procedure (4). Improvements in multimodal imaging techniques help to understand the pathogenesis of SO, aid the early diagnosis of SO, and monitor disease progression and response to therapy (5).…”

Section: Introductionmentioning

confidence: 99%

Case report: Sympathetic ophthalmia after vitrectomies in a patient with Von Hippel–Lindau syndrome

Zhuang

Gao²,

Sun³

et al. 2023

Front. Med.

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BackgroundSympathetic ophthalmia (SO) is a rare but sight-threatening uveitis, and most observations have been made after typical manifestations occur. This report focuses on the choroidal changes detected by multimodal imaging at the presymptomatic stage of SO, which is implicated in the early recognition of SO.Case presentationA 21-year-old woman suffered from decreased vision in the right eye and was diagnosed with retinal capillary hemangioblastomas associated with Von Hippel–Lindau syndrome. The patient underwent two 23-G pars plana vitrectomies (PPVs), soon after which typical signs of SO manifested. SO resolved quickly after the oral administration of prednisone and remained stable during the follow-up of more than 1 year. The retrospective analysis revealed preexisting bilaterally increased choroidal thickness, dots of flow void on the choroid, and choriocapillaris en-face slabs in optical coherence tomography angiography (OCTA) after the first PPV, which were all reversed by corticosteroid treatment.ConclusionThe case report highlights the involvement of the choroid and choriocapillaris at the presymptomatic stage of SO after the first inciting event. Abnormally thickened choroid and flow void dots suggested that SO had started and an ensuing surgery would run the risk of exacerbating SO. OCTA scanning of both eyes should be ordered routinely for patients with a history of trauma or intraocular surgeries, especially before the next surgical intervention. The report also suggests that non-human leukocyte antigen gene variation may also regulate the progression of SO, which requires further laboratory investigations.

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