Sympathetic ophthalmia after 27-G pars plana vitrectomy
Abstract Background Sympathetic ophthalmia (SO) is a bilateral diffuse uveitis that can arise after ocular trauma or ocular surgery in the inciting eye. Pars plana vitrectomy (PPV) is one of the risk factors for SO. Several reports have described SO developing after 23- and 25-G PPV, but none have d...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12886-021-01961-z |
| _version_ | 1818451507276677120 |
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| author | Yasuyuki Takai Yoshihito Sakanishi Masahiro Okamoto Nobuyuki Ebihara |
| author_facet | Yasuyuki Takai Yoshihito Sakanishi Masahiro Okamoto Nobuyuki Ebihara |
| author_sort | Yasuyuki Takai |
| collection | DOAJ |
| description | Abstract Background Sympathetic ophthalmia (SO) is a bilateral diffuse uveitis that can arise after ocular trauma or ocular surgery in the inciting eye. Pars plana vitrectomy (PPV) is one of the risk factors for SO. Several reports have described SO developing after 23- and 25-G PPV, but none have described SO occurring after 27-G PPV. We describe herein a case of SO after 27-G PPV for rhegmatogenous retinal detachment. Case presentation A 42-year-old woman presented with visual disturbance in the right eye. Best-corrected visual acuity (BCVA) was 6/200 in the right eye. Fundus examination revealed off-macula retinal detachment with retinal tears at both ends of retinal lattice degeneration at the temporal-oven peripheral retina of the right eye. We therefore performed 27-G sutureless PPV on the right eye. After 12 days, the retina was reattached, and BCVA improved to 6/30 in the right eye. Fifteen days postoperatively, she experienced headache and reduced vision in both eyes. Symptoms gradually worsened, and she visited our hospital 21 days postoperatively. BCVA was 6/30 in the right eye and 6/15 in the left eye. Slit-lamp examination revealed uveitis in the anterior chambers of both eyes, and fundus examination showed papillitis and subretinal detachment at the posterior poles of both eyes. Optical coherence tomography revealed subretinal fluid in the maculae of both eyes and fluorescein angiography showed multiple hyperfluorescent leakage sites in the retinal pigment epithelium. Cerebrospinal fluid examination showed pleocytosis and human leukocyte antigen testing showed expression of the DR04 phenotype; therefore, the patient was diagnosed with SO. She was treated with steroid therapy, and her visual disturbance subsided and the subretinal fluid improved as well. Her BCVA was 6/15 for the right eye and 6/5 for the left eye 93 days after the initial surgery. Conclusion The present case shows that even if the sclerotomy site of 27-G PPV is small, there is still a risk of SO occurring in the eyes of patients who underwent transconjunctival vitrectomy. Ophthalmologists should recognize SO as complication of 27-G PPV and carry out proper management as early as possible. |
| first_indexed | 2024-12-14T21:08:18Z |
| format | Article |
| id | doaj.art-322ddcc6040b4b0abb68e5121b1fcb91 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-14T21:08:18Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-322ddcc6040b4b0abb68e5121b1fcb912022-12-21T22:47:21ZengBMCBMC Ophthalmology1471-24152021-05-012111510.1186/s12886-021-01961-zSympathetic ophthalmia after 27-G pars plana vitrectomyYasuyuki Takai0Yoshihito Sakanishi1Masahiro Okamoto2Nobuyuki Ebihara3Department of Ophthalmology, Juntendo University Urayasu HospitalDepartment of Ophthalmology, Juntendo University Urayasu HospitalDepartment of Ophthalmology, Juntendo University Urayasu HospitalDepartment of Ophthalmology, Juntendo University Urayasu HospitalAbstract Background Sympathetic ophthalmia (SO) is a bilateral diffuse uveitis that can arise after ocular trauma or ocular surgery in the inciting eye. Pars plana vitrectomy (PPV) is one of the risk factors for SO. Several reports have described SO developing after 23- and 25-G PPV, but none have described SO occurring after 27-G PPV. We describe herein a case of SO after 27-G PPV for rhegmatogenous retinal detachment. Case presentation A 42-year-old woman presented with visual disturbance in the right eye. Best-corrected visual acuity (BCVA) was 6/200 in the right eye. Fundus examination revealed off-macula retinal detachment with retinal tears at both ends of retinal lattice degeneration at the temporal-oven peripheral retina of the right eye. We therefore performed 27-G sutureless PPV on the right eye. After 12 days, the retina was reattached, and BCVA improved to 6/30 in the right eye. Fifteen days postoperatively, she experienced headache and reduced vision in both eyes. Symptoms gradually worsened, and she visited our hospital 21 days postoperatively. BCVA was 6/30 in the right eye and 6/15 in the left eye. Slit-lamp examination revealed uveitis in the anterior chambers of both eyes, and fundus examination showed papillitis and subretinal detachment at the posterior poles of both eyes. Optical coherence tomography revealed subretinal fluid in the maculae of both eyes and fluorescein angiography showed multiple hyperfluorescent leakage sites in the retinal pigment epithelium. Cerebrospinal fluid examination showed pleocytosis and human leukocyte antigen testing showed expression of the DR04 phenotype; therefore, the patient was diagnosed with SO. She was treated with steroid therapy, and her visual disturbance subsided and the subretinal fluid improved as well. Her BCVA was 6/15 for the right eye and 6/5 for the left eye 93 days after the initial surgery. Conclusion The present case shows that even if the sclerotomy site of 27-G PPV is small, there is still a risk of SO occurring in the eyes of patients who underwent transconjunctival vitrectomy. Ophthalmologists should recognize SO as complication of 27-G PPV and carry out proper management as early as possible.https://doi.org/10.1186/s12886-021-01961-zSympathetic ophthalmiaVitrectomyUveitis |
| spellingShingle | Yasuyuki Takai Yoshihito Sakanishi Masahiro Okamoto Nobuyuki Ebihara Sympathetic ophthalmia after 27-G pars plana vitrectomy BMC Ophthalmology Sympathetic ophthalmia Vitrectomy Uveitis |
| title | Sympathetic ophthalmia after 27-G pars plana vitrectomy |
| title_full | Sympathetic ophthalmia after 27-G pars plana vitrectomy |
| title_fullStr | Sympathetic ophthalmia after 27-G pars plana vitrectomy |
| title_full_unstemmed | Sympathetic ophthalmia after 27-G pars plana vitrectomy |
| title_short | Sympathetic ophthalmia after 27-G pars plana vitrectomy |
| title_sort | sympathetic ophthalmia after 27 g pars plana vitrectomy |
| topic | Sympathetic ophthalmia Vitrectomy Uveitis |
| url | https://doi.org/10.1186/s12886-021-01961-z |
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