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Sympathetic ophthalmia: epidemiology and cohort-based assessment of clinical outcomes
  1. Tim J Patterson1,
  2. Weidong Gu2,
  3. David Eliason2,
  4. William Rojas-Carabali3,
  5. Bernett Lee4,
  6. Padmamalini Mahendradas5,
  7. Jyotrimay Biswas6,
  8. Parthopratim Dutta Majumder6,
  9. Manisha Agarwal7,
  10. Carlos Pavesio8,9,
  11. Vishali Gupta10,
  12. Rupesh Agrawal11,
  13. Richard James Blanch12,13
  1. 1NIMDTA, Belfast, UK
  2. 2Defense Health Agency, Falls Church, Virginia, USA
  3. 3Neurosciences Research Group (NEUROS), NeuroVitae Center for Neuroscience, Universidad Del Rosario, Escuela de Medicina y Ciencias de la Salud, Bogota, Colombia
  4. 4Lee Kong Chian School of Medicine, Singapore
  5. 5Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, Karnataka, India
  6. 6Uvea Clinic, Vision Research Foundation, Chennai, Tamil Nadu, India
  7. 7Vitreo-retina, Dr. Shroff's Charity Eye Hospital, New Delhi, New Delhi, India
  8. 8Moorfields Eye Hospital NHS Foundation Trust, London, UK
  9. 9UCL Institute of Ophthalmology, London, UK
  10. 10Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India
  11. 11Department of Ophthalmology, National Healthcare Group Eye Institute, Singapore
  12. 12Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
  13. 13Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Richard James Blanch; R.J.Blanch{at}bham.ac.uk

Abstract

Background The purpose of this study was to report the incidence, time after inciting event, aetiology and risk after specific intraocular procedures and the visual outcomes associated with sympathetic ophthalmia (SO) occurrence.

Methods This study reports data from multiple retrospective cohorts: retrospective population-based data were extracted from the TRICARE service network (between 2017 and 2021) and retrospective case-based data from the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) database (cohorts from the UK, South India and North India).

Results There were 159 patients with SO identified. The length of time from sensitising event to SO occurrence was a median of 151 days (range: 6–9100 days).

In the TRICARE database, 2 patients developed SO after open globe trauma and primary repair (of 615 eyes, rate 0.33%; 95% CI 1.26% to 1.30%). None developed SO after vitrectomy (total of 23 903 events; 95% CI 0% to 0.012%). The combined North Indian and UK cohorts reported 78.6% (81 patients) after trauma, 18.45% (19 patients) after elective surgery.

Visual outcomes were reported in the OASIS database for 98.01% of patients (155 of 157 patients). The median presenting and final best corrected visual acuity (BCVA) for the inciting eye were no perception of light, the median presenting and final BCVA for the sympathising eye were 0.65 and 0.3 logMAR, respectively.

Conclusion This study identified 159 cases of SO. With poor visual outcomes in the inciting eye, early diagnosis and management are crucial for optimising visual outcomes in the sympathising eye.

  • Inflammation
  • Trauma
  • Epidemiology

Data availability statement

Data may be obtained from a third party and are not publicly available.

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Data availability statement

Data may be obtained from a third party and are not publicly available.

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Footnotes

  • X @@Tim_J_Patterson, @warc97

  • Contributors RA was involved in all stages of the manuscript. DE, WR-C, BL, PM, JB, PDM, CP, WG and MA VG were involved with conduct, reporting and acquisition of data. TP and RB were involved with planning, conduct, reporting, conception, design, data analysis and interpretation. RB accepts full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.