title: SYMPATHETIC OPHTHALMIA: Clinicopathologic Correlation in a Consecutive Case Series.
abstract: OBJECTIVE
  To correlate the clinical course of sympathetic ophthalmia with the histological and immunohistochemical characteristics of the enucleated inciting eye.
  
  
  METHODS
  A consecutive case series with baseline clinical features and subsequent histopathologic findings.
  
  
  RESULTS
  Evaluation of the 16 enucleated inciting eyes (blind and painful) disclosed that 9 of the 16 had typical histology, fulfilling the criteria for sympathetic ophthalmia of diffuse granulomatous inflammation. Among the 16, 11 sustained previous penetrating trauma, 4 underwent previous eye surgery, and 1 patient presented with an unknown etiology. Patients with atypical histology (7 of 7) were taking corticosteroids at the time of enucleation. Only 2 of 9 patients with typical histology were taking corticosteroids at the time of enucleation. At 6 months after enucleation of the inciting eye, 4 of the 7 patients with atypical histology had a visual acuity of ≥20/40 compared with 8 of 8 patients (100%) with typical histology. On a 4-point scale (0-3+), the choroidal infiltrate of the 9 histopathologically typical eyes showed an average of 2.5+ CD68 (macrophages), 2.5+ CD20 (B cells), and 1.5+ CD3 (T cells).
  
  
  CONCLUSIONS
  Histopathologic findings had minimal correlation with the clinical course of sympathetic ophthalmia. Corticosteroid treatment before enucleation may influence the pathologic confirmation of sympathetic ophthalmia. The predominance of B lymphocytes and macrophages over T lymphocytes may represent different stages of the disease process.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Hassan A
authors.initials: HA
authors.lastname: Aziz
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Young
authors.forename: Janet L
authors.initials: JL
authors.lastname: Davis
authors.forename: Sander R
authors.initials: SR
authors.lastname: Dubovy
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D019070:Cell Lineage; D002648:Child; D002833:Choroiditis / Q000473:pathology*; D004804:Eosinophils / Q000473:pathology*; D015353:Eye Enucleation; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009879:Ophthalmia, Sympathetic / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D012307:Risk Factors; D015423:Scleritis / Q000473:pathology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D007166:Immunosuppressive Agents