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Sympathetic ophthalmia.

Francisco Max Damico1, Szilárd Kiss, Lucy H Young

  • 1Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA.

Seminars in Ophthalmology
|November 12, 2005
PubMed
Summary
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Sympathetic ophthalmia is a rare autoimmune eye inflammation following trauma. Prompt treatment with corticosteroids and immunosuppressants offers a good visual prognosis.

Area of Science:

  • Ophthalmology
  • Immunology

Background:

  • Sympathetic ophthalmia (SO) is a rare, bilateral granulomatous uveitis.
  • It occurs subsequent to ocular trauma or surgery in one eye.
  • Inflammation in the fellow eye typically manifests within 3 months post-injury.

Purpose of the Study:

  • To review the clinical presentation, diagnosis, and management of sympathetic ophthalmia.
  • To discuss the autoimmune basis and differential diagnoses of this condition.
  • To highlight the importance of timely immunomodulatory therapy for visual outcomes.

Main Methods:

  • Review of clinical findings and diagnostic criteria for SO.
  • Discussion of proposed autoimmune mechanisms involving T cells and choroidal melanocytes.
  • Analysis of treatment strategies, including corticosteroids and other immunosuppressants.

Related Experiment Videos

Main Results:

  • Clinical presentation includes anterior uveitis with mutton-fat keratic precipitates and posterior uveitis with vitritis and choroidal lesions.
  • Diagnosis relies on clinical presentation and history of ocular trauma/surgery.
  • Effective treatment involves high-dose oral corticosteroids, with other immunosuppressants used for refractory cases.

Conclusions:

  • Sympathetic ophthalmia is an autoimmune T-cell-mediated response.
  • Prompt diagnosis and aggressive immunomodulatory therapy are crucial for preserving vision.
  • The role of enucleation remains debated, but visual prognosis is generally favorable with appropriate management.