OBJECTIVE: To describe the visual and clinical outcomes of 3 patients with sympathetic ophthalmia treated with a combination of systemic steroids and methotrexate. METHODS: This was a small, descriptive case series. RESULTS: We reported 3 cases of post-traumatic sympathetic ophthalmia treated with steroids and methotrexate. Two patients had inciting eyes with no light perception on presentation, while one had a best-corrected visual acuity (BCVA) of counting fingers. The initial BCVA of the sympathizing eyes ranged from 20/20 to 20/50. Control of ocular inflammation was achieved using methotrexate (12.5 to 15 mg weekly) in addition to oral steroids and topical therapy. The final BCVA of the sympathizing eyes ranged from 20/20 to 20/30, indicating that good visual outcomes were attainable with steroids and methotrexate as part of the maintenance regimen. None of the patients developed adverse side-effects from methotrexate. CONCLUSION: This small case series demonstrated the effectiveness and safety of methotrexate for control of intraocular inflammation in sympathetic ophthalmia.
Ophthalmia, Sympathetic ; Methotrexate ; Panuveitis ; Steroids

Sympathetic ophthalmia is a rare, diffuse, granulomatous inflammation of the entire uvea, usually bilateral, which occurs days, months, or years after penetrating ocular injury or intraocular surgery. This presented case was a 34 years old male patient injured his left eye suspecting a scleral laceration. The exciting eye(left) was eviscerated 8 days after injury and sympathetic eye(right) was developed sympathetic ophthalmia 8 weeks after injury. A brief review of the related literatures is presented.
Adult ; Humans ; Inflammation ; Lacerations ; Male ; Ophthalmia, Sympathetic* ; Uvea

Sympathetic ophthalmia is rare, bilateral, diffuse, and granulomatous inflammation of the uvea, which occurs days, months, or years after penetrating ocular injury or intraocular surgery. The cause of the disease is still unknown but seems to be an autoimmune disease by reaction of delayed hypersensitivity mediated by T-Iymphocyte. There have been 4 cases reports on sympathetic ophthalmia domestically untill now, which occurred after ocular penetrating injury. The authors experienced two cases of sympathetic ophthalmia; one occurred after implantation of intraocular lens and the other occurred after cyclocryotherapy. A brief review of the related literatures is presented.
Autoimmune Diseases ; Hypersensitivity, Delayed ; Inflammation ; Lenses, Intraocular ; Ophthalmia, Sympathetic* ; Uvea

Sympathetic ophthalmia is rare, bilateral, diffuse, and granulomatous inflammation of the uvea, which occurs days, months, or years after penetrating ocular injury or intraocular surgery. The cause of the disease is still unknown but seems to be an autoimmune disease by reaction of delayed hypersensitivity mediated by T-Iymphocyte. There have been 4 cases reports on sympathetic ophthalmia domestically untill now, which occurred after ocular penetrating injury. The authors experienced two cases of sympathetic ophthalmia; one occurred after implantation of intraocular lens and the other occurred after cyclocryotherapy. A brief review of the related literatures is presented.
Autoimmune Diseases ; Hypersensitivity, Delayed ; Inflammation ; Lenses, Intraocular ; Ophthalmia, Sympathetic* ; Uvea

Immunosuppressive agent has been used as a therapeutic agent for Endogeneous posterior uveitis[EPU]. But serious side effect of steriod or cyclosporine and frequent recurrence of ocular inflammation warrant the addition of other immunosuppressive agents. In this study, we evaluated the therapeutic effectiveness of low dose triple therapy using steroid, cyclosporine and azathioprine when combination therapy with steroid and cyclosporine had failed. We reviewed the records of 10 Behcet's patients[18 eyes]and 2 sympathetic ophthalmia patients[2 eyes]who had been resistant to steroid and cyclosporine combination therapy. The median follow up duration of triple therapy was 16.3 months. Recurrence, severity of inflammation, systemic manifestations associated with Behcet's disease, and side effect of therapeutic agents were evaluated. There was a significantly decrease in the frequency[0.37/month during pretriple therapy and 0.14/month after triple therapy]and severity of ocular inflammation[p<0.01]. The frequency and severity of systemic manifestations also decreased. Visual acuity remained stable in 7 eyes[35%]and improved in 13 eyes[65%]. No serious side effects or newly developed side effect were developed during triple therapy except reversible mild anemia in 1 patient. The results of our study suggest that triple agent immunosuppressive therapy is well tolerated and appears to be effective for the severe uveitis which is refraction to steroid and cyclosporine combination therapy.
Anemia ; Azathioprine ; Cyclosporine* ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Inflammation ; Ophthalmia, Sympathetic ; Recurrence ; Uveitis* ; Visual Acuity

Sympathetic ophthalmia is a bilateral of the entire uveal tissue almost caused by a traumatic perforating wound that involves uveal tract. It is recently rare and unknown etiology. Authors have experienced with a rare case of sympathetic ophthalmia. Patient was a 36 years old Korean female who injured her left eye with limbal laceration and prolapse iris, and developed sympathetic ophthalmia on posterior segment is involved first after 36 days. The exciting eye is not to enucleated because of relatively good visual acuity and won't operation. Both eyes was improved fairly after corticosteroid theraphy per os. A brief review of the related literatures is present.
Adult ; Female ; Humans ; Iris ; Lacerations ; Ophthalmia, Sympathetic* ; Prolapse ; Visual Acuity ; Wounds and Injuries

It is well known that the development of sympathetic ophthalmia is almost always secondary to an accidental or surgical penetrating wound of the eye. This presented case was a 28 year old male who injured his left eye with a scleral laceration with prolapse of uveal tissue and developed sympathetic ophthalmia after 8 weeks. The exciting eye (left) was enucleated and showed typical findings of sympathetic ophthalmia. The patient has done well on steroids and whenever the steroids was diminished or discontinued, there was aggrevation of inflammation. The visual result was relatively favorable.
Adult ; Humans ; Inflammation ; Lacerations ; Male ; Ophthalmia, Sympathetic* ; Prolapse ; Steroids ; Wounds, Penetrating

PURPOSE: To describe a case of sympathetic ophthalmia due to corneal perforation caused by exposure keratitis in a patient with recurrent sphenoid wing meningioma. CASE SUMMARY: A 34-year-old female patient presented with proptosis in her left eye caused by left sphenoid greater wing meningioma despite tumor debulking surgery and radiation treatment. The cornea was perforated with prolapsed iris due to exposure keratitis, thus enucleation of the left eye was performed. After 2 weeks, an inflammatory reaction occurred in both eyes, keratic precipitates on corneal endothelium, exudative retinal detachment, and multiple granulomatous nodules on the right eye retina. The patient was diagnosed with sympathetic ophthalmia, thus enucleation of the left eye and debulking of the tumor were performed followed by a high-dose intravenous steroid therapy. At 5 months postoperatively, slit lamp biomicroscope showed no chamber reaction; improved disc swelling and exudative retinal detachment in the right eye were observed. CONCLUSIONS: Despite conservative treatment for exposure keratitis due to proptosis caused by malignant sphenoid meningioma, corneal perforation can develop. Because sympathetic ophthalmia can occur, the other eye should be monitored.
Adult ; Cornea ; Corneal Perforation* ; Endothelium, Corneal ; Exophthalmos ; Female ; Humans ; Iris ; Keratitis ; Meningioma* ; Ophthalmia, Sympathetic* ; Retina ; Retinal Detachment

PURPOSE: To investigate the clinical outcome of glaucoma surgery performed in patients with painful blind glaucomatous eyes. METHODS: A single-center, retrospective, interventional case series was performed by reviewing the medical records of 74 glaucoma patients (74 eyes) who underwent Ahmed glaucoma valve (AGV) implantation or trabeculectomy for painful blind eyes from October 2004 to January 2014. Blindness was defined as visual acuity less than hand motion at the time of surgery. Preoperative and postoperative intraocular pressure (IOP), number of anti-glaucoma medications, and presence of pain were compared in the patients grouped according to the type of glaucoma surgery. The glaucoma type, history of previous glaucoma surgery and postoperative failure/complications were also evaluated. RESULTS: AGV implantation was performed in 42 eyes (56.8%) of 42 patients, and trabeculectomy was performed in 32 eyes (43.2%) of 32 patients. The average IOP decreased from 41.73 +/- 11.77 mm Hg before surgery to 14.29 +/- 9.34 mm Hg at five years after the surgery (p < 0.001, paired t-test). The IOP was not significantly different between the groups at any follow-up time point (p = 0.949, linear mixed model). Overall, three patients (4.1%) still experienced eye pain after surgery, IOP greater than 30 mm Hg was observed in eight eyes (10.8%), and additional surgery was required in 11 eyes (14.9%). Evisceration was required in only two eyes (2.7%). Sympathetic ophthalmia was not found in any patient during the follow-up period. CONCLUSIONS: Glaucoma surgery including AGV implantation/trabeculectomy was effective and safe even for painful blind eyes. The procedure may be considered as an alternative to enucleation as an initial surgical option for painful blind glaucomatous eyes.
Blindness ; Eye Pain ; Follow-Up Studies ; Glaucoma* ; Hand ; Humans ; Intraocular Pressure ; Medical Records ; Ophthalmia, Sympathetic ; Retrospective Studies ; Trabeculectomy ; Visual Acuity

No abstract available.
Choroid/pathology ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic/*etiology/pathology ; Retina/pathology ; Retinal Detachment/surgery ; Vitrectomy/*adverse effects