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Svácová H, Izák M, Tímová S, Svác J, Bieliková A. [Sympathetic ophthalmia]. CESKOSLOVENSKA OFTALMOLOGIE 1990; 46:218-22. [PMID: 2354539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The authors give an account of a case of sympathetic ophthalmia which was successfully managed by reoperation of the injured eye, corticoids and immunosuppressive drugs. Sympathetic ophthalmia developed after perforation of the cornea along with traumatic cataract one month following the accident. It was manifested by irritation of the anterior segment of both eyes and marked exudation into the area of the posterior pole of the sympathizing eye. On the injured eye surgical reconstruction of the anterior segment was performed and concurrently broad spectrum antibiotics and corticoids were administered. On this therapy the anterior segment of both eyes began to improve, while the exudation into the area of the posterior pole of the sympathizing eye proceeded; therefore immunosuppressive therapy was started. The manifestations of sympathetic ophthalmia receded gradually. After an alternative way of corticoid reduction was started, a relapse of sympathetic ophthalmia occurred. The relapse was suppressed by a temporary increase of the dosage. Three months after the development of sympathetic ophthalmia, using the treatment described, the uveal inflammation of both eyes receded. At present, two years after the accident, both eyes are in a satisfactory condition with normal visual acuity--on the injured eye with an aphakic correction.
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Abstract
Sympathetic ophthalmia was given its complete clinical description by William Mackenzic in 1840, and fully described in terms of its histopathology by Ernst Fuchs in 1905. A review of epidemiologic data from the 19th and 20th centuries reveals that acceptable statistical studies have yet to be carried out, but suggests that the disease has always been of extremely low incidence. Further, there does not appear to be a markedly decreased incidence in the "modern era." The etiology of the disease remains elusive, although the pathogenesis appears to be due to delayed hypersensitivity (cell-mediated immunity), possibly directed at a surface membrane antigen that is shared by photoreceptors, retinal pigment epithelium and choroidal melanocytes. The only effective therapy remains preventive enucleation of the injured eye, despite modern usage of immunosuppressive agents. Studies have suggested that early enucleation of a blind exciting eye can improve the prognosis for the sympathizing eye.
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Abstract
We reviewed the charts of 20 patients with sympathetic ophthalmia who were seen in the uveitis clinic at the Eye and Ear Infirmary within an 11-year period. Of these 20 patients 14 maintained 20/50 or better visual acuity in at least one eye. We found early enucleation to be associated with a better visual prognosis, possibly due to earlier diagnosis and faster, more aggressive therapy rather than a reduction in antigenic load. The clinical appearance of Dalen-Fuchs nodules appears to indicate a more severe stage of disease. Chlorambucil was useful in patients with severe disease. To be effective and to lessen its side effects chlorambucil was given in daily dosages that were increased weekly over a short period to achieve bone marrow suppression. After a course of chlorambucil therapy intraocular inflammation could be controlled with topical steroids alone.
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Bao LL, Fan XD. Long-term follow-up of sympathetic ophthalmia treated by combination of Chinese traditional and Western medicine. J TRADIT CHIN MED 1988; 8:89-93. [PMID: 3412019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Dubois C, Kantelip B, Bacin F. [Sympathetic ophthalmia: current clinical data apropos of 3 cases]. BULLETIN DES SOCIETES D'OPHTALMOLOGIE DE FRANCE 1988; 88:725-30. [PMID: 3228957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Inouye S, Ideta H, Ishikawa M, Yoshino Y. [Sympathetic ophthalmia following vitrectomy and/or retinal detachment surgery]. NIPPON GANKA GAKKAI ZASSHI 1988; 92:372-6. [PMID: 3046261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Charlin JF, Brasseur G, Hauville C, Hubault D, Langlois J. [Sympathetic ophthalmia. Treatment with plasma exchange]. OPHTALMOLOGIE : ORGANE DE LA SOCIETE FRANCAISE D'OPHTALMOLOGIE 1987; 1:305-7. [PMID: 3153878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Reynard M, Riffenburgh RS, Maes EF. Effect of corticosteroid treatment and enucleation on the visual prognosis of sympathetic ophthalmia. Am J Ophthalmol 1983; 96:290-4. [PMID: 6614106 DOI: 10.1016/s0002-9394(14)77816-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A retrospective clinicopathologic study, conducted to determine the course of disease in 30 cases of sympathetic ophthalmia with clinical follow-up of at least six months (average, 12.7 years), showed that 21 of 30 patients retained visual acuities of 20/50 or better in the sympathizing eye. The severity of inflammation graded histologically in the exciting eye did not correlate with the clinical course of final visual acuity in the sympathizing eye. Enucleation of the exciting eye within two weeks of the onset of symptoms was associated with a relatively benign clinical course (P = .008). Corticosteroid treatment in patients who underwent enucleation more than two weeks after the onset of symptoms was associated with a good visual outcome (P = .009). Early enucleation of a blind exciting eye and corticosteroid treatment appear to be important variables that influence the visual prognosis in the sympathizing eye.
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Lardenet F, You B, Schooneman F, Raspiller A. [Sympathetic ophthalmia treated by plasma exchange]. BULLETIN DES SOCIETES D'OPHTALMOLOGIE DE FRANCE 1983; 83:239-41. [PMID: 6616734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Bronner A, Kosmann P, Kunnert C. [A case of confirmed sympathetic ophthalmia]. BULLETIN DES SOCIETES D'OPHTALMOLOGIE DE FRANCE 1981; 81:635-7. [PMID: 7318097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Lubin JR, Albert DM, Weinstein M. Sixty-five years of sympathetic ophthalmia. A clinicopathologic review of 105 cases (1913--1978). Ophthalmology 1980; 87:109-21. [PMID: 7383540 DOI: 10.1016/s0161-6420(80)35270-6] [Citation(s) in RCA: 148] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A retrospective clinicopathologic review of 105 cases of sympathetic ophthalmia showed histologic features of prognostic significance and evaluated the role of therapy. Classic descriptions omit retinal changes, but 58.0% of our cases had retinal detachment and 42.2% showed intraretinal inflammation. The optic nerve and/or meninges were inflamed in 51%. Optic atrophy was seen in 54.4%. Plasma cells are said to be characteristically absent, but 65.0% of steroid-treated and 85.7% of cases before the steroid era showed plasma cell infiltration. Severity of inflammation pathologically correlated with final visual outcome, and corticosteroid therapy changed both the character and severity of inflammation. Early enucleation of the exciting eye after onset of symptoms in the fellow eye was found to improve visual prognosis. Electron microscopy performed on fresh tissue and choroidal cell cultures revealed no viral particles, and viral and mycoplasma cultures all proved negative.
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Kraus-Mackiw E, Müller-Ruchholtz W. [Sympathetic eye diseases: diagnosis and therapy]. Klin Monbl Augenheilkd 1980; 176:131-9. [PMID: 7412151 DOI: 10.1055/s-2008-1057415] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Hamard H, Campinchi R, Fougères R, Douet B, Brègeat P. [Sympathetic ophthalmia and antilymphocyte serum]. BULLETIN DES SOCIETES D'OPHTALMOLOGIE DE FRANCE 1972; 72:845-8. [PMID: 4353754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Brendel W, Seifert J, Lob G. Effect of 'maximum immune suppression' with thoracic duct drainage, ALG, azathioprine and cortisone in some neurological disorders. Proc R Soc Med 1972; 65:531-5. [PMID: 5035906 PMCID: PMC1643939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Tabor GL. Trauma to eye and orbit. THE JOURNAL OF TRAUMA 1968; 8:1089-95. [PMID: 5722123 DOI: 10.1097/00005373-196811000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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KOTARI M, KOIKE H. [2 cases of sympathetic ophthalmia showing a favorable response to treatment with Corson]. RINSHO GANKA. JAPANESE JOURNAL OF CLINICAL OPHTHALMOLOGY 1962; 16:709-12. [PMID: 14458767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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TOKAREVA BA, GEIMOS EK. [The use of corticosteroids in the treatment of sympathetic ophthalmia]. Vestn Oftalmol 1961; 74:29-31. [PMID: 13777217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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ETIENNE-MARTIN P, KLEPPING C, PETIT A. [Hypoglycemia in peptic ulcer]. ANNALES D'ENDOCRINOLOGIE 1958; 19:524-30. [PMID: 13559786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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CRAWFORD JS. Sympathetic ophthalmia controlled by continuous cortisone therapy over a four-year period. Am J Ophthalmol 1957; 44:412-5. [PMID: 13458314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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STANKOVIC I. [Sympathetic ophthalmia as a therapeutic problem]. MEDICINSKI GLASNIK 1957; 11:98-102. [PMID: 13482744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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PAEZ ALLENDE F. [2 Cases of sympathetic ophthalmia cured with cortisone, hydrocortisone and broad spectrum antibiotics]. REVISTA DE LA ASOCIACION MEDICA ARGENTINA 1956; 70:243-5. [PMID: 13379729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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STURMAN RM. Sympathetic ophthalmia cured by cortisone and ACTH. EYE, EAR, NOSE & THROAT MONTHLY 1956; 35:372-5. [PMID: 13317956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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