Sympathetic ophthalmia. Immunopathological findings

Area of Science:

• Ophthalmology
• Immunology
• Pathology

Background:

• Sympathetic ophthalmia (SO) is a rare, bilateral inflammatory condition affecting the eyes.
• It typically follows penetrating ocular injury or intraocular surgery.
• Clinical diagnosis is crucial, but histopathological findings can vary.

Observation:

• Ocular tissues from six patients with clinical SO were analyzed using immunohistochemistry.
• Four cases exhibited classic SO features: granulomatous infiltration and Dalen-Fuchs nodules.
• Two cases lacked typical nodules but showed choroidal infiltrates of lymphocytes.

Findings:

• The granulomas in classic SO cases were primarily composed of monocytes derived from bone marrow.
• In atypical cases, choroidal infiltrates consisted mainly of T-helper and B lymphocytes.
• Macrophages and epithelioid cells were absent in the lymphocyte-predominant infiltrates.

Implications:

• The study highlights a spectrum of immunopathological and histopathological presentations in SO.
• Understanding this variability is essential for accurate diagnosis and management of sympathetic ophthalmia.
• Further research may elucidate the mechanisms underlying these diverse immune responses in SO.