Sympathetic ophthalmitis following vitreoretinal surgery: Does antecedent trauma make a difference?

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Inflammatory Eye Disease

Background:

• Sympathetic ophthalmitis (SO) is a known complication following vitrectomy.
• Limited data exists on how prior penetrating ocular trauma influences SO presentation after vitrectomy.

Purpose of the Study:

• To compare the clinical presentation and outcomes of SO in eyes with and without a history of penetrating ocular trauma, diagnosed post-vitreoretinal surgery.

Main Methods:

• A comparative case series included 17 patients diagnosed with SO after vitreoretinal surgery (1995-2011).
• Patients were divided into two groups: Group I (n=7) with prior penetrating injury and Group II (n=10) without.
• Demographic and clinical data were analyzed, noting prior systemic steroid use in Group I.

Main Results:

• Group I (trauma) showed a shorter interval to SO diagnosis (1.5 vs. 8 months) and a higher incidence of neurosensory detachments (100% vs. 30%) compared to Group II.
• Inciting vision at presentation was worse in Group I (28.5% no light perception vs. 80% in Group II).
• Trends suggested differences in optic disc/retinal vessel involvement and fluorescein angiography findings.

Conclusions:

• SO in patients with prior penetrating ocular trauma presents earlier and mimics central serous chorioretinopathy.
• Pre-existing penetrating trauma and prior systemic steroid use may influence SO presentation and visual outcomes.