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Two cases of sympathetic ophthalmia after vitrectomy for ocular trauma Hirotoshi Orita 1 , Masashi Kakinoki 1 , Osamu Sawada 1 , Masahito Ohji 1 1Department of Ophthalmology, Shiga University of Medical Science pp.983-990
Published Date 2024/8/15
DOI https://doi.org/10.11477/mf.1410215249
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Abstract Purpose:To report two cases of sympathetic ophthalmia following vitrectomy for ocular trauma, in which good vision was achieved with prompt steroid treatment.

Case 1:36-year-old woman. The right eye was bruised, resulting in rupture of the globe. On the same day, scleral suturing, ultrasonic phacoemulsification of the lens, and vitrectomy were performed, and the patient did well. On day 62 after the injury, granulomatous panuveitis of both eyes was observed, for which the patient was treated with methylprednisolone 1000 mg intravenously for 3 days, then switched to prednisolone 40 mg orally that was tapered off. The prednisolone was discontinued at 13 months post-treatment, but no relapse. At 15 months post-treatment, both eyes were doing well with a best-corrected visual acuity(BCVA)of 1.5. HLA-DR4 was positive.

Case 2:64-year-old man. The right eye was bruised with anterior chamber hemorrhage, goniodialysis, and lens subluxation. The anterior chamber hemorrhage resolved spontaneously. At 2 months after the injury, the patient underwent iris reconstruction, phacoemulsification and aspiration of the lens, intraocular lens intrascleral fixation and vitrectomy. The patient's postoperative course was good, but on postoperative day 50, he patient presented with granulomatous panuveitis of both eyes. HLA-DR4 was negative. After a 3-day infusion of 1,000 mg of methylprednisolone, the patient was started on prednisolone 30 mg, with repeated exacerbations and remissions observed during titration. Thereafter, the dose was tapered off, and at 8 months after the start of steroid treatment, the patient had no relapse occurred under prednisolone 10 mg and both eyes were doing well with BCVA of 1.2 in the right eye and 1.5 in the left eye.

Conclusion:Here we described two cases of sympathetic ophthalmia following vitrectomy for ocular trauma, that had a good course with early steroid treatment. When sympathetic ophthalmia is diagnosed, early treatment initiation may lead to good vision.


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