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S. Onal, L. Sobrin, C.S. Foster; Long–Term Immunosuppressive Therapy for Sympathetic Ophthalmia . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2430.
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© ARVO (1962-2015); The Authors (2016-present)
To report the long–term outcomes of patients with sympathetic ophthalmia (SO) treated with immunosuppressive therapy. Mechanisms of injury, visual acuities and degree of inflammation before and after immunosuppressive therapy, type of immunosuppressive therapy and complications were recorded.
Charts of patients with SO examined at one uveitis referral center from 1987 to 2004 were reviewed.
Four patients were male and 3 were female. Patients were followed for a median follow–up period of 24 months (range, 5–216 months). Mean age at presentation was 44.8±14.9 years (range, 20–63 years). The exciting insult was penetrating trauma in five patients (71.4%). SO was secondary to plana vitrectomy in two patients. The interval between the insult and the onset of SO ranged from 2 months to 24 years. Complications encountered were secondary glaucoma, cataract and subretinal neovascular membrane formation. Conventional immunosuppressive agents including methotrexate, azathioprine, cyclosporine A, mycophenolate mofetil, chlorambucil and sirolimus either as monotherapy or combination therapy along with systemic corticosteroids were used. High dose systemic corticosteroids were only used to control severe flare–ups of inflammation. Visual acuity improved with treatment in all eyes. Final visual acuity was 20/40 or better in six eyes. All patients were free of inflammation at the last follow–up.
Prompt and prolonged treatment of SO with immunosuppressive therapy led to a high percent of visual preservation in this study.
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