Case Of Sympathetic Ophthalmia Research Articles

Clinical analysis of 30 cases of sympathetic ophthalmia

目的 探讨交感性眼炎的治疗及预防方法.方法回顾分析30例交感性眼炎的年龄、性别、致伤原因、受伤部位、潜伏期、发生率、临床表现、治疗及预后,讨论交感性眼炎发病机制、环磷酰胺疗效、摘除伤眼问题及预防方法.结果伤口24小时以内修复的眼球穿孔伤和同期内眼手术发生交感性眼炎22例,复发4例,复发率18.18%;伤口24小时以后修复及未修复的眼球穿孔伤发生交感性眼炎8例,复发4例,复发率50%.二者之间无显著差异(X2=3.04 P＞0.05).交感性眼炎发生后再摘除伤眼者既不能缩短病程,也不能防止复发.应用皮质类固醇、环磷酰胺等药物治疗,炎症控制,视力均提高.结论及时准确处理伤眼及内眼手术可减少交感性眼炎的发生和复发,交感性眼炎发生后摘除伤眼要慎重选择适应证,联合应用环磷酰胺、皮质类固醇药物治疗效果较好。

CASE REPORT Sympathetic Ophthalmia after a Hyphema due to Nonpenetrating Trauma

Purpose: To report a case of sympathetic ophthalmia occurring after nonpenetrating ocular trauma. Methods: Interventional case report. Results: An 18-year-old white male presented with sympathetic ophthalmia four weeks after a hyphema from a nonpenetrating bungee cord injury. Vision was 20/20; there were keratic precipitates, anterior chamber cells, vitritis, and discrete yellow deep choroidal lesions consistent with Dalen-Fuch's nodules OU. The uveitis was treated with topical, oral, and periocular corticosteroids and the oral immunosuppressives cyclosporine and mycophenolate mofetil. Vision remained 20/20 OU for the first year of follow-up; vision OD then deteriorated to 20/50 over the next year with the formation of a posterior subcapsular cataract OD. Conclusion: Sympathetic ophthalmia may result from nonpenetrating ocular trauma. Ophthalmologists should be aware of this as prompt intervention is warranted.

Peripapillary choroidal atrophy in sympathetic ophthalmia and management with triple-agent immunosuppression

Purpose: To describe the occurrence of peripapillary choroidal atrophy and experience with triple-agent immunosuppression in three cases of sympathetic ophthalmia. Materials and methods: Retrospective chart review of three cases of sympathetic ophthalmia with peripapillary choroidal atrophy. Results: Three patients with sympathetic ophthalmia were managed with steroid pulse therapy and triple-agent immunosuppression. All three patients subsequently developed peripapillary choroidal atrophy. Conclusions: Peripapillary choroidal atrophy can occur in sympathetic ophthalmia and may indicate a severe form of inflammation which would benefit from triple-agent immunosuppression.

Visual prognosis and sympathetic ophthalmia.

Sympathetic ophthalmia is probably the ocular disorder best known to practitioners outside of ophthalmology. It is characterized by a bilateral, nonnecrotizing granulomatous panuveitis that occurs after intentional or unintentional trauma to the exciting eye. So far, the identity of the inciting antigen has not been delineated with certainty. The sequelae from sympathetic ophthalmia have declined markedly in this century as a result of earlier diagnosis, use of corticosteroids, and better management of ocular injuries, in large part due to improved surgical techniques. Cases of sympathetic ophthalmia, however, still occur with their severe sight-threatening complications, which impose on ophthalmologists the importance of prompt diagnosis and aggressive treatment in order to achieve good visual outcome.

Contact transscleral cyclophotocoagulation with diode laser in refractory glaucoma.

To evaluate the clinical effectiveness of contact transscleral cyclophotocoagulation (CTCP) with diode laser. Forty-eight seeing eyes and 20 blind and painful eyes of 68 patients suffering from refractory glaucoma were treated using a diode laser (EOS3000, Laser Science) coupled with a 400-microns optic fiber ending in a 3-mm focusing tip. Sixteen to twenty 3.9-J (2.6 W x 1.5 to 2.5 s) laser spots were placed over 360 degrees, 1.5 mm from the corneolimbal junction. In the seeing-eye group, the follow-up was 20.7 +/- 8.14 months, pre- and posttreatment IOPs were 37.1 +/- 11.27 and 19.5 +/- 8.73 mmHg respectively (p < 0.0001), and success (IOP > 2 and < or = 21 mmHg) was 70.8%. No significant visual acuity change was found in the successful eyes, whereas a significant visual acuity reduction was found in the unsuccessful cases (p = 0.03). In the blind-eye group, the follow-up was 20.5 +/- 8.54 months, pre- and post-treatment IOPs were 50.7 +/- 15.05 and 20.6 +/- 13.99 mmHg respectively (p < 0.0001), and success (remission of pain) was 100%. As for complications, one seeing eye developed a spontaneously-resolved vitreous hemorrhage and one seeing and one blind eye became hypotonic, though no phthysis was observed. No conjunctival or lens damage was detected, and no scleral thinning was revealed by ultrasound biomicroscopy. No case of sympathetic ophthalmia was found. Diode laser can be successfully employed for CTCP in refractory glaucoma.

Long-Term Follow-Up of Severely Injured Eyes Following Globe Rupture

There is little information concerning the outcome of severely traumatized eyes, with little visual potential, which are not removed. We studied 50 eyes, which had suffered severe globe rupture, had visual acuities of no better than hand motion, and were not removed within 2 weeks of injury. Seventeen (34%) of the 50 eyes were later removed. Of the 17, nine had become painful. The other 33 eyes, which were not removed, remained comfortable over a mean follow-up of 66 months (12-161 months). Thirty (70%) of 43 eyes, which had follow-up of at least two months, became phthisical. There were no cases of sympathetic ophthalmia. These results suggest that the majority of severely-injured eyes become phthisical, but do not require removal for pain.

CULTIVATION OF VIRUS IN A CASE OF SYMPATHETIC OPHTHALMIA.

CULTIVATION OF VIRUS IN A CASE OF SYMPATHETIC OPHTHALMIA.

SOME CASES OF SYMPATHETIC OPHTHALMIA

Acta OphthalmologicaVolume 17, Issue 4 p. 388-411 SOME CASES OF SYMPATHETIC OPHTHALMIA J. P. Jensen, J. P. Jensen EYE-DEPARTMENT OF THE KOMMUNEHOSPITAL, COPENHAGENSearch for more papers by this author J. P. Jensen, J. P. Jensen EYE-DEPARTMENT OF THE KOMMUNEHOSPITAL, COPENHAGENSearch for more papers by this author First published: December 1939 https://doi.org/10.1111/j.1755-3768.1939.tb07377.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume17, Issue4December 1939Pages 388-411 RelatedInformation

SYMPATHETIC OPHTHALMIA

Cases of sympathetic ophthalmia, as every ophthalmologist knows, are not a rarity. One is immediately on the lookout for this disorder in case of injury to the eye in which there has been either a perforation of the eyeball (operative cases included) or a rupture of the tunics of the eye. This is especially true when the opening involves the ciliary region, or so-called danger zone. Does the average ophthalmologist look for this condition when there has been no perforation or rupture of the eyeball? Does he even consider this possibility when he is confronted with an ocular injury caused by a blow from a fist or even as innocent an object as a snowball? A careful search of the literature fails to show undisputed cases arising without perforation or rupture of the eyeball (cases of melanosarcoma excepted). Jackson¹stated : "The occurrence of true sympathetic ophthalmia

OBSCURE SYMPATHETIC PHENOMENA

Notwithstanding the great amount of attention that has been directed of late years to the subject of sympathetic ophthalmia and sympathetic phenomena generally, ophthalmologists are still far from arriving at a thorough understanding of the causes that induce these conditions. It is only by collecting facts that the desired explanation can ultimately be found. Therefore, I think that it is the duty of ophthalmologists to record any cases presenting peculiar or unusual features. That is why I venture to publish my notes on the cases of two patients who have recently come under my care. Many years ago, Dr. Mules of London introduced the practice of eviscerating the eyeball, in lieu of extirpation, and afterward inserting in the place of its contents a hollow glass ball, which was kept in position by sutures through the cut edges of the conjunctiva. As several cases of sympathetic ophthalmia were reported as the

Spontaneous Cures of Hopeless Diseases

Spontaneous cures, being nature's technic of curing, are of immense theoretical and practical interest. Hamburger's idea of collecting from the ophthalmic literature and from his personal experience hopeless cases in which the conditions have healed spontaneously is a felicitous one. Of the cases reported, the following are worthy of mention : three cases of sympathetic ophthalmia in which the condition disappeared during an attack of an acute febrile disease ; one case of severe tuberculosis of the cornea and conjunctiva which cleared up after an attack of erysipelas of the face ; another case of the same type in which the condition disappeared after a severe tuberculin anaphylaxis ; a case of recurrent hemorrhages in the vitreous in which the condition was cleared up by repeated venesections ; a few cases of severe trachoma with pannus which cleared up by an induced gonorrheic ophthalmia ; one case of optic atrophy in which the patient

Case of Sympathetic Ophthalmia from Which a Secondary Cataract Had Been Removed after the Administration of Salvarsan

Case of Sympathetic Ophthalmia from Which a Secondary Cataract Had Been Removed after the Administration of Salvarsan

THE DANGER OF SYMPATHETIC OPHTHALMIA FROM THE USE OF THE CAUTERY IN TREATING IRIS-PROLAPSEOTHER METHODS OF TREATMENT

In 1897 Trousseau 1 reported three cases of sympathetic ophthalmia (two of his own and one of Kalt's) following the use of the galvanocautery in treating prolapse of the iris; and in the same year 2 I felt impelled by my own experience to second the warning given by Trousseau. Since then I have happened to notice the histories of seven cases of sympathetic ophthalmia in which the authors mentioned incidentally that a wound or an iris prolapse had been cauterized a suitable length of time before the outbreak of the disease in the second eye. These cases were reported by the following authors: Alexander, 3 Darier, 4 Alberti, 5 Dimmer, 6 and Fuchs, 7 who each report a case occurring after cauterization of an iris prolapse or a cystoid scar; and Cohn 8 mentions two cases from the clinic of Silex in which a wound was cauterized before the

CLINICAL AND PATHOLOGIC NOTES ON SYMPATHETIC OPHTHALMIA.

Of the six cases of sympathetic ophthalmia which I have had the opportunity to observe in progress, only three have had features unusual enough to warrant my giving their histories. Case 1. —F. W., aged 27, came to me Feb. 6, 1896, stating that while at work in a machine-shop, that morning, he was struck in the left eye by a piece of steel. I found the right eye normal, with vision 20/20 +; the left eye had a very small perforating wound of the cornea and lens, with the latter so opaque as to entirely obscure the fundus. Vision was equal to fingers at two feet. As there was nothing to indicate the location of the piece of steel, and the giant magnet produced no effect, it was decided to wait until the lens became entirely opaque and then extract, with the hope of being able to see the fundus.

A CASE OF SYMPATHETIC OPHTHALMIA TWO WEEKS AFTER ENUCLEATION OF THE INJURED EYE.Read in the Section of Ophthalmology, at the Forty-first Annual Meeting of the American Medical Association, Nashville, Tenn., May, 1890.

The patient whose history I report was a boy 11 years of age. He was injured in a quarrel with another boy on the third day of last October, and was brought to my office immediately after the injury. He had been struck by a rock the size of a man's fist, and from the absence of any marks on the face must have received the full force of the blow in the eye. Examination showed a complete vertical rupture of the cornea and a slight extension of the wound into the sclerotic below. Exactly to what extent the contents of the globe had suffered it was impossible at the time to determine. The serious nature of the injury was explained to the friends, and the mere possibility of retaining the eyeball, though shrunken, was placed before them ; while the probable necessity of its removal at any future time