Sympathetic ophthalmia. Histopathologic and fluorescein angiographic correlation

Area of Science:

• Ophthalmology
• Pathology

Background:

• Sympathetic ophthalmia is a rare, bilateral granulomatous inflammation following ocular trauma or surgery.
• Cataract extraction can precipitate sympathetic ophthalmia, though it is uncommon.

Observation:

• A case of sympathetic ophthalmia is presented 15 months after cataract extraction in a previously traumatized eye.
• Clinical and histopathologic examination of the affected eyes were performed.
• Fluorescein angiography was utilized to assess vascular changes.

Findings:

• Histopathology showed numerous Dalen-Fuchs nodules and choroidal granulomas, leading to choriocapillaris obliteration and Bruch's membrane disruption.
• Clinical observation revealed prominent Dalen-Fuchs nodules in the sympathizing eye.
• Angiography demonstrated initial hypofluorescence followed by late hyperfluorescence, correlating with pathology in the exciting eye.
• Breaks in Bruch's membrane were identified, a finding not previously reported in sympathetic ophthalmia.

Implications:

• This case expands the understanding of sympathetic ophthalmia's histopathologic features.
• The findings highlight the importance of correlating clinical, angiographic, and histopathologic data in diagnosing and understanding sympathetic ophthalmia.
• The identification of breaks in Bruch's membrane may offer new insights into the pathogenesis of sympathetic ophthalmia.