[Sympathetic ophthalmia in an elderly man]

A 78-years-old man suffered from sympathetic ophthalmia. He had been treated with 5-fluorouracil (5-FU) for metastasis of colon cancer in the liver. He received a perforating eye injury in the left eye thereafter the eye became phthisic. Two months after the injury, he noticed visual disturbance in the right eye. He was treated with large doses of systemic corticosteroid after a diagnosis of uveitis of the right eye, but the visual acuity of the right eye became worse. The eye showed non-specific diffuse uveitis. A diagnosis of sympathetic ophthalmia was made from previous history and ocular findings. We enucleated the injured eye and continued the systemic corticosteroid. Then the right eye improved. Histopathological examination of the enucleated eye revealed the choroid was infiltrated with a granulomatous lesion of lymphocytes and epithelioid cells. HLA typing showed DR4, DR8, DR52, DR53, and DQ1, and we made a final diagnosis of sympathetic ophthalmia. It is probable that the clinical findings were modified by the 5-FU treatment and the patient's advanced age.