Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report

Deepesh Arora; Anuj Sharma; Devesh Sharma; Dinesh Sharma

doi:doi:10.11648/j.ijovs.20230801.14

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Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report

Deepesh Arora, Anuj Sharma, Devesh Sharma, Dinesh Sharma

Published in International Journal of Ophthalmology & Visual Science (Volume 8, Issue 1)

Received: 5 February 2023 Accepted: 6 March 2023 Published: 16 March 2023

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Abstract

We report a case of 11 year old young girl referred with complaint of right sided photophobia and pain following faucet induced trauma to left eye 3 months ago, followed by loss of sight in left eye. Patient presented to us with prepthisical left eye and anterior segment uveitis in right eye. Fundus picture revealed cream colour white nodules confirmed as Dalen Fuchs on fundus fluorescein angiography and presence of hypereflective lesions placed at level of retinal pigment epithelium with disruption of the inner and outer segment (IS/OS) junction on spectral domain optical coherence tomography. Ultrasonogram-B-scan confirmed closed funnel retinal detachment in traumatized left eye and increased choroidal thickness in sympathizing right eye. She underwent orbital computerized axial tomography scan to rule out intraocular foreign body. She was diagnosed as a case of delayed sympathetic ophthalmia. Subsequently she was put on intensive topical with oral steroids and immunesuppressive therapy constituted with oral azathioprine and methotrexate continued for one year and tapered on resolution of presenting signs. At final follow up sympathizing eye was quiescent and sympathetic eye was prepthisical. Sympathetic ophthalmia needs to be distinguished from other ocular auto-immune disorder such as Vogt Koyanagi Harada disease and Acute Multifocal Pigment Placoid Epitheliopathy to which it bears striking resemblance. As these disorders have variable response to treatment with widely differing outcome one must keep that in view while managing them. It is important to remember as the treatment is prolonged recurrences and patient drop outs are commonly noted.

Published in	International Journal of Ophthalmology & Visual Science (Volume 8, Issue 1)
DOI	10.11648/j.ijovs.20230801.14
Page(s)	20-24
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

APMPPE, Sympathetic, Trauma, Uveitis, VKHD

References

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APA Style

Deepesh Arora, Anuj Sharma, Devesh Sharma, Dinesh Sharma. (2023). Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report. International Journal of Ophthalmology & Visual Science, 8(1), 20-24. https://doi.org/10.11648/j.ijovs.20230801.14

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ACS Style

Deepesh Arora; Anuj Sharma; Devesh Sharma; Dinesh Sharma. Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report. Int. J. Ophthalmol. Vis. Sci. 2023, 8(1), 20-24. doi: 10.11648/j.ijovs.20230801.14

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AMA Style

Deepesh Arora, Anuj Sharma, Devesh Sharma, Dinesh Sharma. Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report. Int J Ophthalmol Vis Sci. 2023;8(1):20-24. doi: 10.11648/j.ijovs.20230801.14

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@article{10.11648/j.ijovs.20230801.14,
  author = {Deepesh Arora and Anuj Sharma and Devesh Sharma and Dinesh Sharma},
  title = {Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {8},
  number = {1},
  pages = {20-24},
  doi = {10.11648/j.ijovs.20230801.14},
  url = {https://doi.org/10.11648/j.ijovs.20230801.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20230801.14},
  abstract = {We report a case of 11 year old young girl referred with complaint of right sided photophobia and pain following faucet induced trauma to left eye 3 months ago, followed by loss of sight in left eye. Patient presented to us with prepthisical left eye and anterior segment uveitis in right eye. Fundus picture revealed cream colour white nodules confirmed as Dalen Fuchs on fundus fluorescein angiography and presence of hypereflective lesions placed at level of retinal pigment epithelium with disruption of the inner and outer segment (IS/OS) junction on spectral domain optical coherence tomography. Ultrasonogram-B-scan confirmed closed funnel retinal detachment in traumatized left eye and increased choroidal thickness in sympathizing right eye. She underwent orbital computerized axial tomography scan to rule out intraocular foreign body. She was diagnosed as a case of delayed sympathetic ophthalmia. Subsequently she was put on intensive topical with oral steroids and immunesuppressive therapy constituted with oral azathioprine and methotrexate continued for one year and tapered on resolution of presenting signs. At final follow up sympathizing eye was quiescent and sympathetic eye was prepthisical. Sympathetic ophthalmia needs to be distinguished from other ocular auto-immune disorder such as Vogt Koyanagi Harada disease and Acute Multifocal Pigment Placoid Epitheliopathy to which it bears striking resemblance. As these disorders have variable response to treatment with widely differing outcome one must keep that in view while managing them. It is important to remember as the treatment is prolonged recurrences and patient drop outs are commonly noted.},
 year = {2023}
}

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TY  - JOUR
T1  - Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report
AU  - Deepesh Arora
AU  - Anuj Sharma
AU  - Devesh Sharma
AU  - Dinesh Sharma
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PY  - 2023
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DO  - 10.11648/j.ijovs.20230801.14
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 20
EP  - 24
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20230801.14
AB  - We report a case of 11 year old young girl referred with complaint of right sided photophobia and pain following faucet induced trauma to left eye 3 months ago, followed by loss of sight in left eye. Patient presented to us with prepthisical left eye and anterior segment uveitis in right eye. Fundus picture revealed cream colour white nodules confirmed as Dalen Fuchs on fundus fluorescein angiography and presence of hypereflective lesions placed at level of retinal pigment epithelium with disruption of the inner and outer segment (IS/OS) junction on spectral domain optical coherence tomography. Ultrasonogram-B-scan confirmed closed funnel retinal detachment in traumatized left eye and increased choroidal thickness in sympathizing right eye. She underwent orbital computerized axial tomography scan to rule out intraocular foreign body. She was diagnosed as a case of delayed sympathetic ophthalmia. Subsequently she was put on intensive topical with oral steroids and immunesuppressive therapy constituted with oral azathioprine and methotrexate continued for one year and tapered on resolution of presenting signs. At final follow up sympathizing eye was quiescent and sympathetic eye was prepthisical. Sympathetic ophthalmia needs to be distinguished from other ocular auto-immune disorder such as Vogt Koyanagi Harada disease and Acute Multifocal Pigment Placoid Epitheliopathy to which it bears striking resemblance. As these disorders have variable response to treatment with widely differing outcome one must keep that in view while managing them. It is important to remember as the treatment is prolonged recurrences and patient drop outs are commonly noted.
VL  - 8
IS  - 1
ER  -

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Author Information

Deepesh Arora

Department of Vitreo-retina and Uvea, Amritsar Eye Clinic, Dehradun, India
Anuj Sharma

Department of Vitreo-retina and Uvea, Amritsar Eye Clinic, Dehradun, India
Devesh Sharma

Department of Cornea and Refractive Surgery, Amritsar Eye Clinic, Dehradun, India
Dinesh Sharma

Department of Cataract and Refractive Surgery, Amritsar Eye Clinic, Dehradun, India

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APA Style

Deepesh Arora, Anuj Sharma, Devesh Sharma, Dinesh Sharma. (2023). Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report. International Journal of Ophthalmology & Visual Science, 8(1), 20-24. https://doi.org/10.11648/j.ijovs.20230801.14

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ACS Style

Deepesh Arora; Anuj Sharma; Devesh Sharma; Dinesh Sharma. Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report. Int. J. Ophthalmol. Vis. Sci. 2023, 8(1), 20-24. doi: 10.11648/j.ijovs.20230801.14

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AMA Style

Deepesh Arora, Anuj Sharma, Devesh Sharma, Dinesh Sharma. Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report. Int J Ophthalmol Vis Sci. 2023;8(1):20-24. doi: 10.11648/j.ijovs.20230801.14

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@article{10.11648/j.ijovs.20230801.14,
  author = {Deepesh Arora and Anuj Sharma and Devesh Sharma and Dinesh Sharma},
  title = {Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {8},
  number = {1},
  pages = {20-24},
  doi = {10.11648/j.ijovs.20230801.14},
  url = {https://doi.org/10.11648/j.ijovs.20230801.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20230801.14},
  abstract = {We report a case of 11 year old young girl referred with complaint of right sided photophobia and pain following faucet induced trauma to left eye 3 months ago, followed by loss of sight in left eye. Patient presented to us with prepthisical left eye and anterior segment uveitis in right eye. Fundus picture revealed cream colour white nodules confirmed as Dalen Fuchs on fundus fluorescein angiography and presence of hypereflective lesions placed at level of retinal pigment epithelium with disruption of the inner and outer segment (IS/OS) junction on spectral domain optical coherence tomography. Ultrasonogram-B-scan confirmed closed funnel retinal detachment in traumatized left eye and increased choroidal thickness in sympathizing right eye. She underwent orbital computerized axial tomography scan to rule out intraocular foreign body. She was diagnosed as a case of delayed sympathetic ophthalmia. Subsequently she was put on intensive topical with oral steroids and immunesuppressive therapy constituted with oral azathioprine and methotrexate continued for one year and tapered on resolution of presenting signs. At final follow up sympathizing eye was quiescent and sympathetic eye was prepthisical. Sympathetic ophthalmia needs to be distinguished from other ocular auto-immune disorder such as Vogt Koyanagi Harada disease and Acute Multifocal Pigment Placoid Epitheliopathy to which it bears striking resemblance. As these disorders have variable response to treatment with widely differing outcome one must keep that in view while managing them. It is important to remember as the treatment is prolonged recurrences and patient drop outs are commonly noted.},
 year = {2023}
}

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TY  - JOUR
T1  - Delayed Sympathetic Ophthalmia Involving Posterior Segment a Dilemma: A Case Report
AU  - Deepesh Arora
AU  - Anuj Sharma
AU  - Devesh Sharma
AU  - Dinesh Sharma
Y1  - 2023/03/16
PY  - 2023
N1  - https://doi.org/10.11648/j.ijovs.20230801.14
DO  - 10.11648/j.ijovs.20230801.14
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 20
EP  - 24
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20230801.14
AB  - We report a case of 11 year old young girl referred with complaint of right sided photophobia and pain following faucet induced trauma to left eye 3 months ago, followed by loss of sight in left eye. Patient presented to us with prepthisical left eye and anterior segment uveitis in right eye. Fundus picture revealed cream colour white nodules confirmed as Dalen Fuchs on fundus fluorescein angiography and presence of hypereflective lesions placed at level of retinal pigment epithelium with disruption of the inner and outer segment (IS/OS) junction on spectral domain optical coherence tomography. Ultrasonogram-B-scan confirmed closed funnel retinal detachment in traumatized left eye and increased choroidal thickness in sympathizing right eye. She underwent orbital computerized axial tomography scan to rule out intraocular foreign body. She was diagnosed as a case of delayed sympathetic ophthalmia. Subsequently she was put on intensive topical with oral steroids and immunesuppressive therapy constituted with oral azathioprine and methotrexate continued for one year and tapered on resolution of presenting signs. At final follow up sympathizing eye was quiescent and sympathetic eye was prepthisical. Sympathetic ophthalmia needs to be distinguished from other ocular auto-immune disorder such as Vogt Koyanagi Harada disease and Acute Multifocal Pigment Placoid Epitheliopathy to which it bears striking resemblance. As these disorders have variable response to treatment with widely differing outcome one must keep that in view while managing them. It is important to remember as the treatment is prolonged recurrences and patient drop outs are commonly noted.
VL  - 8
IS  - 1
ER  -

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