Abstract
Abstract: :
Purpose: Sympathetic Ophtalmia (SO) is a bilateral granulomatous panuveitis that occurs after a penetrating injury that involves the uvea of one eye, the reported prevalence of SO in the population is low, developing in 0.1% to 0.3% of patient following traumatic ocular injuries , in this report we present the cases of SO occurring during the last two years and examine the relationship between visual outcome and the clinical management with steroids in high doses. Methods: We report four cases of SO who were seen at the Retinal and Vitreous Clinic of the Fundación Hospital de Nuestra Señora de la Luz from 2000 to 2001. All patients were followed up at least 6 months. We recorded the followed characteristics: age, sex, type of injury, the interval between trauma-surgery and the onset of disease, clinical presentation, therapy, complications and final visual acuity. Results: SO occurred in four patient after an accidental open globe injury. Three were males and one female (18-59 years old). Symptoms developed in 3 cases within 12 weeks of the injury, and one patient showed symptoms 30 years later. Two patients had additional procedures besides the original repair in the exciting eye before the onset of SO ( scleral buckle and vitrectomy in one case and evisceration in another). The interval between trauma and surgical repair range, 2 to 11 days, mean 5 days. All the patients were put on a regimen of oral prednisone at an initial dose of l.5 mg/kg per day, the dose was slowly tapered based on the therapeutic response. In this report 3 patients achieved a visual acuity of 20/40 or better in contrast one patient with a final visual acuity worse than 20/400. Conclusion: Prompt and aggressive use of systemic steroids can improve the visual outcome of patients with sympathetic ophthalmia.
Keywords: 570 retinochoroiditis • 327 autoimmune disease