Sympathetic Ophthalmia

Hassan A. Aziz, Harry W. Flynn, Ryan C. Young, Janet L. Davis, Sander R. Dubovy

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Purpose: To correlate the clinical course of sympathetic ophthalmia with the histological and immunohistochemical characteristics of the enucleated inciting eye. Methods: A consecutive case series with baseline clinical features and subsequent histopathologic findings. Results: Evaluation of the 16 enucleated inciting eyes (blind and painful) disclosed that 9 of the 16 had typical histology, fulfilling the criteria for sympathetic ophthalmia of diffuse granulomatous inflammation. Among the 16, 11 sustained previous penetrating trauma, 4 underwent previous eye surgery, and 1 patient presented with an unknown etiology. Patients with atypical histology (7 of 7) were taking corticosteroids at the time of enucleation. Only 2 of 9 patients with typical histology were taking corticosteroids at the time of enucleation. At 6 months after enucleation of the inciting eye, 4 of the 7 patients with atypical histology had a visual acuity of ≥20/40 compared with 8 of 8 patients (100%) with typical histology. On a 4-point scale (0-3+), the choroidal infiltrate of the 9 histopathologically typical eyes showed an average of 2.5+ CD68 (macrophages), 2.5+ CD20 (B cells), and 1.5+ CD3 (T cells). Conclusion: Histopathologic findings had minimal correlation with the clinical course of sympathetic ophthalmia. Corticosteroid treatment before enucleation may influence the pathologic confirmation of sympathetic ophthalmia. The predominance of B lymphocytes and macrophages over T lymphocytes may represent different stages of the disease process.

Original languageEnglish (US)
Pages (from-to)1696-1703
Number of pages8
JournalRetina
Volume35
Issue number8
DOIs
StatePublished - Aug 7 2015
Externally publishedYes

Keywords

  • clinicopathologic correlation
  • immunohistochemistry
  • pathology
  • retina
  • sympathetic ophthalmia
  • uveitis

ASJC Scopus subject areas

  • Ophthalmology

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  • Cite this

    Aziz, H. A., Flynn, H. W., Young, R. C., Davis, J. L., & Dubovy, S. R. (2015). Sympathetic Ophthalmia. Retina, 35(8), 1696-1703. https://doi.org/10.1097/IAE.0000000000000506