Sympathetic ophthalmia in vater association combined with persisting hyperplastic primary vitreous after cyclodestructive procedure.
OBJECTIVE
To report on the occurrence of histology-proven sympathetic ophthalmia in a patient with VATER association and persisting hyperplastic primary vitreous (PHPV) after a cyclodestructive procedure was performed to treat secondary angle-closure glaucoma.


METHODS
The left eye of a 13-year-old boy with VATER association was microphthalmic from birth and had been diagnosed with PHPV at age 1 year. It developed iris neovascularization and secondary angle-closure glaucoma, which was treated by combined cyclocryocoagulation and cyclophotocoagulation. Six weeks later, a bilateral fibrinous iritis developed. Despite intensive topical and systemic steroid treatment, the iritis persisted so that the left blind eye was enucleated.


RESULTS
Histology of the enucleated eye showed a marked intraocular inflammation with lymphocytes, epithelioid cells, and multinuclear giant cells grouped around remnants of melanin-bearing cells.


CONCLUSIONS
Sympathetic ophthalmia may occur in patients with VATER association and PHPV after a secondary angle-closure glaucoma is treated by a combined cyclocryocoagulation and cyclophotocoagulation.
Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, Ruprecht-Karls-University of Heidelberg, Mannheim, Germany. Jost.Jonas@augen.ma.uni-heidelberg.de
J B
JB
Jonas
W
W
Back
G
G
Sauder
U
U
Jünemann
B
B
Harder
U H
UH
Spandau
D000015:Abnormalities, Multiple; D000293:Adolescent; D002924:Ciliary Body / Q000601:surgery; D003452:Cryosurgery / Q000009:adverse effects*; D005124:Eye Abnormalities / Q000150:complications* / Q000175:diagnosis; D015353:Eye Enucleation; D015812:Glaucoma, Angle-Closure / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation / Q000009:adverse effects*; D008297:Male; D009879:Ophthalmia, Sympathetic / Q000175:diagnosis / Q000209:etiology*; D014822:Vitreous Body / Q000002:abnormalities* / Q000473:pathology