Sympathetic ophthalmia in HIV infection. A clinicopathological case report

Miguel A De La Fuente,Patricia Ferrer,Olga Sanchez,Gillermo Fernandez,Nicolas Alejandre,Jose L Sarasa

doi:10.1007/s12348-012-0065-y

Abstract

BackgroundThe purpose of this study is to report a case of sympathetic ophthalmia (SO) in an HIV-infected patient on treatment with highly active antiretroviral therapy (HAART) 9 years after a penetrating eye injury.MethodsThe study utilized clinical course and histopathological findings.ResultsHistopathology of the enucleated right eye showed a predominantly lymphocytic inflammatory infiltration with some plasma cells and epithelioid granulomata in the choroid, suggesting the diagnosis of SO.ConclusionsSO seems to be driven by T lymphocytes, specifically by the CD4 subset of T cells. HIV-infected individuals suffer a decline in CD4 T cell numbers, leading to an acquired immunodeficiency that could halt the development of the inflammatory reaction responsible for SO. The restoration of the CD4 counts by HAART therapy makes HIV-infected individuals as susceptible to SO as non-infected ones. To the best of our knowledge, there are no cases of SO in HIV-infected patients reported in the literature.

Highlights

Meeting presentation: This case report was presented at the annual meeting of the Spanish Multicenter Uveitis Group, February 2011, Valencia, Spain.M
Sympathetic ophthalmia (SO) is a rare, bilateral, nonnecrotizing, granulomatous panuveitis that occurs after ocular surgery or trauma to one eye threatening sight in the uninjured fellow eye
The definition of sympathetic ophthalmia (SO) is that of a rare, bilateral, non-necrotizing, granulomatous panuveitis that occurs after ocular surgery or trauma to one eye threatening sight in the uninjured fellow eye [1]

Summary

Introduction

Meeting presentation: This case report was presented at the annual meeting of the Spanish Multicenter Uveitis Group, February 2011, Valencia, Spain.M. Sympathetic ophthalmia (SO) is a rare, bilateral, nonnecrotizing, granulomatous panuveitis that occurs after ocular surgery or trauma to one eye threatening sight in the uninjured fellow eye. Presentation has been reported from 1 week to 66 years after initial injury [4] with a median time interval of 12 months [2].

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Results

Conclusion