Sympathetic Ophthalmia - An Overview

Ocul Immunol Inflamm. 2023 May;31(4):793-809. doi: 10.1080/09273948.2022.2058554. Epub 2022 May 17.

Abstract

Introduction: Sympathetic ophthalmia (SO) is rare, bilateral granulomatous panuveitis that typically occurs following penetrating or perforating ocular trauma or surgery. This review aims to provide an update on the etiopathogenesis, clinical presentations, diagnosis and treatment of SO.

Methods: Reports cited in MEDLINE database, that analyzed SO in at least 5 patients, published prior to December 1st, 2021 were included.

Results: Initially, SO was associated with penetrating ocular trauma, however, various studies reported an increased incidence of SO after surgical procedures including vitreoretinal surgeries. Multimodal imaging including fluorescein and indocyanine green angiography, optical coherence tomography (OCT) and OCT angiography have added further insights into the understanding of SO. While pulse dose corticosteroids & immunosuppressive drugs are still the treatment of choice, TNF-α blockers & other biologic drugs represent new promising agents.

Conclusion: There is a growing pool of evidence in understanding the pathogenesis of SO. Novel treatment options have provided better prognosis for this potentially blinding condition.

Keywords: Immunosuppression; ocular trauma; panuveitis; sympathetic ophthalmia; vitreoretinal surgery.

Publication types

  • Review

MeSH terms

  • Eye Injuries* / complications
  • Fluorescein Angiography
  • Humans
  • Immunologic Factors / therapeutic use
  • Immunosuppressive Agents / therapeutic use
  • Ophthalmia, Sympathetic* / diagnosis
  • Ophthalmia, Sympathetic* / epidemiology
  • Ophthalmia, Sympathetic* / etiology
  • Prognosis
  • Tomography, Optical Coherence

Substances

  • Immunosuppressive Agents
  • Immunologic Factors