Sympathetic ophthalmitis following vitreoretinal surgery: Does antecedent trauma make a difference?

Abstract

BACKGROUND:

Sympathetic ophthalmitis (SO) has been reported following vitrectomy; however, there is a lack of data on the role of antecedent penetrating ocular trauma impacting the disease manifestation in eyes developing SO following vitrectomy.

AIM:

To report differences in the presentation and outcomes of SO in eyes with or without a history of antecedent penetrating trauma; SO being diagnosed after vitreoretinal (VR) surgery.

DESIGN:

Comparative case series.

METHODS:

Seventeen consecutive patients presenting with SO following VR surgery, diagnosed between 1995 and 2011 were included. Eyes with and without prior penetrating injury were included in Group I (n = 7) and Group II (n = 10), respectively. All Group I patients had received systemic steroids prior to presentation. Demographic and clinical parameters were evaluated.

RESULTS:

Differences were observed between Group I and Group II mainly with regards to time interval between VR surgery and diagnosis of SO (1.5 months vs. 8 months, P = 0.10), presence of neurosensory detachments (100% vs. 30%, P = 0.01), and the inciting eye vision at presentation (nil light perception in 28.5% vs. 80%, P = 0.049). Other differences observed though not statistically significant were optic disc and retinal vessel involvement (42% vs. 70%, P = 0.28), Dalen-Fuchs nodules (localized vs. diffuse) and leaks on fundus fluorescein angiography (pin-head vs. pin-point leak).

CONCLUSION:

SO in patients with antecedent penetrating ocular trauma present early with the central serous chorioretinopathy-like picture. Prior use of systemic steroids might have a bearing on the differences in presentation and the visual acuities between the two groups.

• Authors: Ekta Rishi, Pukhraj Rishi, Bindu Appukuttan, Jaydeep Walinjkar, Jyotirmay Biswas, Tarun Sharma
• Journal: Indian journal of ophthalmology (Indian J Ophthalmol) Vol. 63 Issue 9 Pg. 692-8 (Sep 2015) ISSN: 1998-3689 [Electronic] India
• PMID: 26632123 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Eye Injuries, Penetrating (complications, diagnosis)
• Female
• Fluorescein Angiography
• Follow-Up Studies
• Fundus Oculi
• Humans
• Incidence
• India (epidemiology)
• Male
• Middle Aged
• Ophthalmia, Sympathetic (diagnosis, epidemiology, etiology)
• Retinal Detachment (complications, diagnosis, surgery)
• Retrospective Studies
• Visual Acuity
• Vitreoretinal Surgery (adverse effects)
• Young Adult