Sympathetic ophthalmitis following vitreoretinal surgery: Does antecedent trauma make a difference.
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Date
2015-09
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Abstract
Background: Sympathetic ophthalmitis (SO) has been reported following vitrectomy; however, there is a lack of
data on the role of antecedent penetrating ocular trauma impacting the disease manifestation in eyes developing
SO following vitrectomy. Aim: To report differences in the presentation and outcomes of SO in eyes with
or without a history of antecedent penetrating trauma; SO being diagnosed after vitreoretinal (VR) surgery.
Design: Comparative case series. Methods: Seventeen consecutive patients presenting with SO following VR
surgery, diagnosed between 1995 and 2011 were included. Eyes with and without prior penetrating injury
were included in Group I (n = 7) and Group II (n = 10), respectively. All Group I patients had received systemic
steroids prior to presentation. Demographic and clinical parameters were evaluated. Results: Differences were
observed between Group I and Group II mainly with regards to time interval between VR surgery and diagnosis
of SO (1.5 months vs. 8 months, P = 0.10), presence of neurosensory detachments (100% vs. 30%, P = 0.01), and
the inciting eye vision at presentation (nil light perception in 28.5% vs. 80%, P = 0.049). Other differences
observed though not statistically significant were optic disc and retinal vessel involvement (42% vs. 70%,
P = 0.28), Dalen‑Fuchs nodules (localized vs. diffuse) and leaks on fundus fluorescein angiography (pin‑head
vs. pin‑point leak). Conclusion: SO in patients with antecedent penetrating ocular trauma present early with
the central serous chorioretinopathy‑like picture. Prior use of systemic steroids might have a bearing on the
differences in presentation and the visual acuities between the two groups.
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Keywords
Corticosteroids, immunosuppression, inflammation, sympathetic ophthalmitis, trauma, vitreoretinal surgery
Citation
Rishi Ekta, Rishi Pukhraj, Appukuttan Bindu, Walinjkar Jaydeep, Biswas Jyotirmay, Sharma Tarun. Sympathetic ophthalmitis following vitreoretinal surgery: Does antecedent trauma make a difference. Indian Journal of Ophthalmology. 2015 Sept; 63(9): 692-698.