Sympathetic Ophthalmia Characteristics in Two tertiary centers

Purpose: To describe demographic, clinical features, imaging finding, visual and anatomical outcomes, treatment modalities and complications of sympathetic ophthalmia in two tertiary centers. Methods: The medical records of 16 patients with SO between September 2013 and September 2017 were reviewed. Visual acuity, clinical and imaging findings and response to treatment were evaluated. Results: Sixteen patients with diagnosis of SO were included. Average age at presentation was 42.50±16.42years old (range: 18-67, average age: 38.2 in trauma group and 48.8 in surgery group). There was a statistically significant improvement in best corrected visual acuity (BCVA) of sympathizing eye after treatment.(p:0.26). This change in exciting eye was not statistically significant (p:0.60). All the patients were treated with high dose systemic corticosteroid (62.5% pulse therapy). All patients were treated with immunomodulatory treatment (IMT) cyclosporine was the most common one (56.3%). According to Standardization of the Uveitis Nomenclature (SUN) Working Group classification, after 6 months all patients were in remission (inactive) under IMT. Recurrent inflammation was happened in more than half of study patients. Significant cataract was the most common complication in both exciting and sympathizing eyes (40% and 25% respectively).Conclusion: Nearly 70% of sympathizing eyes achieved favorable visual results (BCVA more than 20/40) with aggressive long term non-steroidal immunosuppressive treatment. Because of high rate of recurrency, aggressive treatment with potent immunosuppressive medications and meticulous long term follow-up is mandatory to obtainfavorable results.