Sympathetic Ophthalmia: Incidence of Ocular Complications and Vision Loss in the Sympathizing Eye
Accepted 27 May 2009. published online 07 August 2009.
Refers to article:
Sympathetic Ophthalmia: What Have We Learned?
H. Nida Sen, Robert B. Nussenblatt
American Journal of Ophthalmology
November 2009 (Vol. 148, Issue 5, Pages 632-633) Full Text |
Full-Text PDF (86 KB)
Purpose
To report the frequency on presentation and subsequent incidence of ocular complications and vision loss in patients with sympathetic ophthalmia (SO) and to describe factors associated with decreased vision in the sympathizing eye.
Design
Multicenter retrospective case series.
Methods
setting: Three academic tertiary care uveitis clinics. study population: Eighty-five patients with SO from 1976 to 2006. observation procedures: Review of existing medical records. main outcome measures: Incident visual acuity (VA) loss to 20/50 or worse and 20/200 or worse and the median acuity over time.
Results
Twenty-six percent of patients with SO presented with a VA of 20/200 or worse in their sympathizing eye. Further development of vision loss to 20/200 or worse occurred at the rate of 10% per person-year (PY). Ocular complications were seen in the sympathizing eye in 47% of patients at presentation; further development of new complications occurred at the rate of 40%/PY. The ocular complications most often associated with decreased vision were cataract and optic nerve abnormality. Exudative retinal detachment and active intraocular inflammation were significantly associated with poorer VA in the sympathizing eye. The benefits of corticosteroids were indirectly demonstrated as their use led to more rapid disease inactivation. Fifty-nine percent of patients maintained a VA of better than 20/50 in their sympathizing eye; and 75% maintained a VA of better than 20/200.
Conclusions
Although ocular complications were seen in many sympathizing eyes with SO, most patients maintained functional VA. The presence of an exudative retinal detachment and active intraocular inflammation correlated with poorer vision in the sympathizing eye.
aBascom Palmer Eye Institute, University of Miami, Miami, Florida
bDepartment of Ophthalmology, University of Illinois at Chicago, Chicago, Illinois
cDepartment of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
dDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
Inquiries to Harry W. Flynn, Jr, Bascom Palmer Eye Institute, 900 17th Street, Miami, FL 33136
ABSTRACT