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Purpose : To investigate the demographic profile, common causes and final visual outcome of patients diagnosed with sympathetic ophthalmia(SO) in a tertiary eye care centre of North East India.
Methods : 2 year Retrospective, hospital based, non-comparative case series. Patients with sympathetic ophthalmia were identified from the uveitis database for the period between August 2013 – August 2015.The diagnosis of SO was made on the basis of a history of ocular trauma or surgery and subsequent development of bilateral uveitis consistent with SO, or histopathological evidence of SO in the enucleated eye.Other investigations included were Fundus fluorescein angiography (FFA), B scan USG and blood investigations.
Results : A total 552 patients presenting to the uveitis clinic,15 patients were diagnosed with SO (2.7%), 33 % . 9 (60%) were male and 6 (40%) were female. Mean age was 46.20 ± 18.63 years (range: 8-70 years).Trauma (Penetrating/Blunt) was the most common cause of SO(n=9; 60%) followed by intraocular surgery (n=6; 40%){4 had vitreo-retinal surgery, 1 BLEB surgery, 1 DLCP}.The mean interval between the inciting event and onset of symptoms was 7 months (range: 1 month – 10 years).Management was given as follows Intravenous methylprednisolone(IVMP) (dose:1mg/day) X3 days followed by oral prednisolone (60-80 mg/d) in tapering doses(n=9; 60%).Oral prednisolone plus topical steroids given in 4 cases(26.66%). Oral immunosuppressives (oral azathioprine- 1-1.5mg/kg.day) were required in 2 cases.In the sympathizing eye the visual acuity at presentation was between 20/200 and 20/40 in majority of cases, by final visit, visin improved to 20/40 in 8 cases, 4 cases had visual acuity of 20/200-20/40.
Conclusion : Sympathetic ophthalmia is a potentially devastating ophthalmic condition which is associated with significant visual morbidity. A higher than usual incidence suggests the possibility of underdiagnosis. Early diagnosis and prompt intervention will bring about favorable visual outcome
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