Posterior sympathetic ophthalmia: a single centre long-term study of 40 patients from North India.
OBJECTIVE
To report 'posterior sympathetic ophthalmia' in North Indian population as an early manifestation of sympathetic ophthalmia.


METHODS
Forty consecutive patients with a diagnosis of sympathetic ophthalmia seen between 1989 and 2004 at our centre were studied for their clinical presentation and disease course. All received systemic corticosteroids and 12 patients, in addition, also received immunosuppressive agents.


RESULTS
There were 28 male and 12 female patients with a median age of 29.4 years. In 22 of the 40 sympathizing eyes, the only presenting sign was the fundus lesions without any associated anterior segment inflammation. Only four eyes showed classically described granulomatous anterior uveitis at presentation. The fundus lesions predominately included exudative retinal detachment (29 eyes), yellowish-white mid-peripheral lesions (10 eyes), optic disc oedema (15 eyes), vasculitis (three eyes), and peripapillary choroidal neovascular membrane (two eyes). Over a median follow-up of 5.2 years, recurrences were seen in 12 of 40 (30%) eyes and were mainly in the anterior segment. Over a median follow-up of 5.2 years, a final visual acuity of 20/40 or better could be achieved in 29/36 (80.5%) eyes.


CONCLUSIONS
In the early stage, sympathetic ophthalmia may present only in the posterior segment without any associated anterior segment inflammation and carries a good visual prognosis. Anterior segment inflammation, however, maybe seen during recurrences.
Gupta
V
V
Department of ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, Union Territory, India. eyepgi@sify.com
Gupta
A
A
Dogra
M R
MR
D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007194:India; D008297:Male; D008875:Middle Aged; D009879:Ophthalmia, Sympathetic / Q000188:drug therapy* / Q000209:etiology; D012008:Recurrence; D014792:Visual Acuity; D055815:Young Adult
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents