Background Sympathetic ophthalmia （SO）, a rare, bilateral, diffuse granulomatous uveitis, usually occurs after open globe injury or intraocular surgery. We sought to identify the risk factors for the development of ...Background Sympathetic ophthalmia （SO）, a rare, bilateral, diffuse granulomatous uveitis, usually occurs after open globe injury or intraocular surgery. We sought to identify the risk factors for the development of SO after open globe injury and describe their demographic and clinical features and outcomes of treatments. Methods A retrospective study of inpatients with globe injury in 15 tertiary referral hospitals of China from January 2001 to December 2005 was conducted. The information of demography, nature and mechanism of injury, time and ways of treatments and outcomes was reviewed. Diagnosis of SO was made based on a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO. Any association between related parameters and development of SO was analyzed. Results Among 9103 patients （9776 eyes） of globe injury, SO occurred after open globe injury in 18 cases with an occurrence rate of 0.37%, vitrectomy of closed globe injury in 2 （0.37%） and perforation of burned eyes in another 2. For open globe injury, the median age （（36.72±13.59） years, P=0.01） was higher in patients with SO; there were no significant effects of sexes, injury type, uvea proplaps, once or multi-intraocular surgery, once or multi-vitrectomy and endophthalmitis on incidence of SO; 0.70% endophthalmitis concurred with SO; 83.33% of SO occurred within 1 year after injury or last ocular surgery. SO developed in a fellow eye one week after evisceration of the perforating burned eye. Good final visual acuity was obtained in sympathizing eyes with prompt treatment. Conclusions For open globe injuries, SO sufferers were relatively older and any injury type could induce SO with equal possibility. The initial open globe injury was more likely to be the trigger of SO than subsequent intraocular surgeries including vitrectomy. Prophylactic enucleation after injury is not recommended.展开更多
A 34 years old male patient presented to us on 15th February 2015,with complaints of mild pain in right eye and a foreign body sensation to the left eye,associated with redness,discomfort and blurring of vision with 4...A 34 years old male patient presented to us on 15th February 2015,with complaints of mild pain in right eye and a foreign body sensation to the left eye,associated with redness,discomfort and blurring of vision with 4 days duration.There was history of a penetrating eye injury to his right eye 20 years ago.Examination showed bilaterally inflamed eyes.The right eye was going into phthisis bulbi.Fundus examination of the left eye showed blurred optic disc with hemorrhagic areas,macular edema and exudative retinal detachments.Systemic review did not show any gross skin changes,neurological signs or dysmorphism.He was initially treated as sympathetic ophthalmitis,but the history and examination noted that he had bilateral sensory neural hearing loss.Fundus fluorescein angiography showed that he had hyperfluorescent spots in the fundus.Thus,the diagnosis was changed to Vogt-Koyanagi-Harada disease.The patient was treated with oral steroids(1 mg/kg per day)and subsequent follow up showed a marked improvement in the ocular findings.展开更多
文摘Background Sympathetic ophthalmia （SO）, a rare, bilateral, diffuse granulomatous uveitis, usually occurs after open globe injury or intraocular surgery. We sought to identify the risk factors for the development of SO after open globe injury and describe their demographic and clinical features and outcomes of treatments. Methods A retrospective study of inpatients with globe injury in 15 tertiary referral hospitals of China from January 2001 to December 2005 was conducted. The information of demography, nature and mechanism of injury, time and ways of treatments and outcomes was reviewed. Diagnosis of SO was made based on a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO. Any association between related parameters and development of SO was analyzed. Results Among 9103 patients （9776 eyes） of globe injury, SO occurred after open globe injury in 18 cases with an occurrence rate of 0.37%, vitrectomy of closed globe injury in 2 （0.37%） and perforation of burned eyes in another 2. For open globe injury, the median age （（36.72±13.59） years, P=0.01） was higher in patients with SO; there were no significant effects of sexes, injury type, uvea proplaps, once or multi-intraocular surgery, once or multi-vitrectomy and endophthalmitis on incidence of SO; 0.70% endophthalmitis concurred with SO; 83.33% of SO occurred within 1 year after injury or last ocular surgery. SO developed in a fellow eye one week after evisceration of the perforating burned eye. Good final visual acuity was obtained in sympathizing eyes with prompt treatment. Conclusions For open globe injuries, SO sufferers were relatively older and any injury type could induce SO with equal possibility. The initial open globe injury was more likely to be the trigger of SO than subsequent intraocular surgeries including vitrectomy. Prophylactic enucleation after injury is not recommended.
文摘A 34 years old male patient presented to us on 15th February 2015,with complaints of mild pain in right eye and a foreign body sensation to the left eye,associated with redness,discomfort and blurring of vision with 4 days duration.There was history of a penetrating eye injury to his right eye 20 years ago.Examination showed bilaterally inflamed eyes.The right eye was going into phthisis bulbi.Fundus examination of the left eye showed blurred optic disc with hemorrhagic areas,macular edema and exudative retinal detachments.Systemic review did not show any gross skin changes,neurological signs or dysmorphism.He was initially treated as sympathetic ophthalmitis,but the history and examination noted that he had bilateral sensory neural hearing loss.Fundus fluorescein angiography showed that he had hyperfluorescent spots in the fundus.Thus,the diagnosis was changed to Vogt-Koyanagi-Harada disease.The patient was treated with oral steroids(1 mg/kg per day)and subsequent follow up showed a marked improvement in the ocular findings.
