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Sympathetic ophthalmia following diode laser cyclophotocoagulation
  1. Abdullah Albahlal1,
  2. Hassan Al Dhibi1,
  3. Sami Al Shahwan1,
  4. Rajiv Khandekar1,
  5. Deepak P Edward1,2
  1. 1King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
  2. 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Deepak P Edward, King Khaled Eye Specialist Hospital, Riyadh 11642, Kingdom of Saudi Arabia; dedward39{at}jhmi.edu

Abstract

Background Sympathetic ophthalmia is a rare form of bilateral uveitis that develops following an ocular penetrating injury to one eye. Several cases of sympathetic ophthalmia have been reported after non-penetrating cyclodestructive procedures including Nd:YAG and diode laser cyclophotocoagulation (CPC) but information on inciting factors and outcome is limited. In this case series we investigated the inciting factors, clinical features, course and outcome of six patients who developed sympathetic ophthalmia after diode CPC.

Methods Six patients who developed sympathetic ophthalmia after diode CPC were identified from the King Khaled Eye Specialist Hospital uveitis database between 2008 and 2013. The medical records of these patients were reviewed for demographic information, ocular history, diode laser parameters, clinical presentation, treatment and outcome.

Results Six patients were diagnosed with sympathetic ophthalmia following treatment with diode laser CPC, an incidence of 0.001% during the study period. Two patients had a history of accidental trauma and all patients had undergone at least one ocular surgery that included a variety of procedures. At presentation, two patients had predominantly posterior segment findings in the sympathising eye, one patient had only anterior segment findings and the rest had panuveitis. All patients were treated with topical and systemic corticosteroids and/or immunosupressive therapy that resulted in complete resolution of inflammation and return to baseline vision in the sympathising eye within 2–48 months of treatment.

Conclusions Sympathetic ophthalmia after diode CPC is rare and is seen in patients with a history of intraocular surgery with or without previous trauma. Early recognition of sympathetic ophthalmia and aggressive management with immunosuppressive therapy results in good outcomes for these patients.

  • Glaucoma
  • Inflammation
  • Immunology
  • Choroid
  • Treatment Medical

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