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SYMPATHETIC OPHTHALMIA: Clinicopathologic Correlation in a Consecutive Case Series
Hassan A Aziz1, Harry W Flynn, Ryan C Young
1Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
Retina (Philadelphia, Pa.)
|February 27, 2015
Summary
Histopathology of the inciting eye showed minimal correlation with the clinical course of sympathetic ophthalmia. Corticosteroid use before enucleation may affect diagnosis, with B cells and macrophages potentially indicating disease stage.
Area of Science:
- Ophthalmology
- Immunology
- Pathology
Background:
- Sympathetic ophthalmia is a rare, bilateral granulomatous inflammation following ocular injury or surgery.
- Accurate diagnosis relies on clinical presentation and histopathological findings, but correlation can be challenging.
Purpose of the Study:
- To correlate clinical outcomes of sympathetic ophthalmia with histopathological and immunohistochemical features of the inciting eye.
- To investigate the influence of pre-enucleation corticosteroid treatment on histopathological findings.
Main Methods:
- A consecutive case series of 16 enucleated eyes with sympathetic ophthalmia.
- Histopathological and immunohistochemical analysis (CD68, CD20, CD3) of ocular tissues.
- Correlation of findings with clinical course and corticosteroid use.
Main Results:
- Nine of 16 eyes showed typical diffuse granulomatous inflammation; 7 had atypical histology, often associated with pre-enucleation corticosteroid use.
- Patients with typical histology had better visual acuity outcomes (100% ≥20/40) at 6 months post-enucleation compared to those with atypical histology (57%).
- Immunohistochemistry revealed a predominance of macrophages (CD68) and B cells (CD20) over T cells (CD3) in typical cases.
Conclusions:
- Histopathological findings demonstrated minimal correlation with the clinical course of sympathetic ophthalmia.
- Pre-enucleation corticosteroid treatment may alter the histopathological confirmation of sympathetic ophthalmia.
- The observed immune cell profile suggests B lymphocytes and macrophages may play a significant role in different disease stages.
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