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Hassan Aziz, Harry Flynn, Ryan Young, Janet Davis, Sander Dubovy; Sympathetic ophathalmia: Histopathological and Immunohistochemical Characteristics. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5383.
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To evaluate histopathological and immunohistochemical characteristics in enucleated globes with sympathetic ophthalmia.
Reevaluation of specimens of enucleated inciting eye of 16 patients clinically diagnosed with sympathetic ophthalmia between 1987 and 2009. Specimens were considered histologically confirmed if there was diffuse granulomatous inflammation. Clinical data collected included prior treatment with immunosuppressive drugs or corticosteroids and time to enucleation after onset of symptoms. An average of 30 stored paraffin sections were obtained from the Florida Lions Ocular Pathology Laboratory and reassessed for histologic characteristics. Immunohistochemical stains included cell lineage markers CD-3, CD-20, CD-68; and cytokine receptors TNF-alpha, IL-4, INF-g, IL-17. A standard 4-point scale (0 - 3+) was used to compare the intensity of the immunohistochemical stains to a positive control slide graded 3+ supplied by the manufacturer.
Histopathologic evaluation of the 16 inciting eyes disclosed that 9 of 16 were diagnostic for sympathetic ophthalmia. In these 9 eyes Dalen-Fuchs nodules were present in 5 of 9 eyes and eosinophils were present in 9 of 9 globes. All patients with negative histology were receiving corticosteroids at the time of enucleation. The infiltrate showed an average of 3+ CD68 (macrophages) , 2+ CD20 (B cells) and 1+ CD3 (T cells). There was no consistent pattern of cytokine receptor staining.
B cells and macrophages were more prevalent than T cells. Presence of eosinophils was a constant finding in histopathologically confirmed cases and may serve as a useful marker for sympathetic ophthalmia. Histological findings are likely altered by time from diagnosis to enucleation and prior treatment.
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