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Sympathetic ophthalmia. A long-term follow-up
Archives of Ophthalmology (Chicago, Ill. : 1960)
|February 1, 1978
Summary
Sympathetic ophthalmia management with corticosteroids offers a 65% chance of retaining good vision. However, complications like glaucoma and cataracts are frequent, requiring long-term, variable steroid treatment and posing challenges during cataract surgery.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Sympathetic ophthalmia is a rare, bilateral granulomatous inflammation following ocular trauma or surgery.
- Understanding its long-term course and treatment outcomes is crucial for patient management.
Observation:
- A 23-year follow-up of 17 sympathetic ophthalmia cases was conducted.
- Sixty-five percent of patients treated with corticosteroids achieved visual acuity of 20/60 or better.
Findings:
- Complications included secondary glaucoma, cataract, exudative retinal detachment, and choroidal scarring.
- Cataract extraction was complex, necessitating steroid dosage adjustments and interventions for glaucoma.
- Relapses occurred frequently, sometimes years after initial resolution, especially with moderate to severe histopathology.
Implications:
- Long-term corticosteroid therapy is often required, with variable duration and risk of relapse.
- Ophthalmologists must anticipate and manage frequent complications, particularly during intraocular surgeries.
- Histopathologic severity correlates with a more challenging and protracted clinical course.