Session Title: Quick Fire Free Paper 3
Session Date/Time: Thursday 11/09/2014 | 14:30-16:00
Paper Time: 15:10
Venue: Boulevard D
First Author: : P.Guzman-Salas MEXICO
Co Author(s): : E. Guinto-Arcos M. Pedroza-Seres
Report the number and characteristics of patients with Sympathetic Ophthalmia, attending a Ocular Inflammation Department, in a period of time, to analyze different epidemiologic characteristics of this disease.
Ocular Inflammation Department, Instituto de Oftalmologia “Conde de Valenciana I.A.P.“, a third level reference center, in Mexico City, Mexico.
A retrospective case series study was performed. We reviewed clinical data from patients attending Ocular Inflammation Department at Instituto de Oftalmologia “Conde de Valenciana I.A.P.“, in Mexico City, Mexico. From January 1st 2007, to December 31st 2013. Clinical electronic records were reviewed of patients with diagnosis of Sympathetic Ophthalmia. Patients records had to comply with clinical data suggestive of this disease, described as: bilateral anterior uveitis, associated with mutton-fat keratic precipitates and vitritis, choroiditis, and papilitis in some cases; and also, could present with serous retinal detachment. Also, the presence of other diseases causing these manifestations had to be excluded previously. After the patients had met our criteria, information was searched in the clinical record for: gender, age, symptoms, type of injury (trauma or surgery), if applicable: type of surgery, time from injury to onset of symptoms, visual acuity in the inciting eye in their first and last consultation, visual acuity in the sympathizing eye in their first and last consultation, findings in examination, treatment received and progression of inciting eye to ptisis bulbi.
We analyzed 20 patients, with average age of 50±19.33 years, with 65% being males. With 50% trauma, 50% surgery distribution regarding the initial event in the inciting eye. In surgery, 40% of patients had Phacoemulsification with intraocular lens implantation, 25% had unspecified Retinopexy procedure, and 35% got other surgical procedures. 60% of patients had a right inciting eye. 100% of cases seek consultation because of decreased vision in the sympathizing eye. Time between injury and onset of symptoms had and average of 104.45±134.41 months. 75% of patients had vision between no light perception and LogMAR 3 initially in the inciting eye, with a final vision in 90% between no light perception and LogMAR 3. Visual acuity in the sympathizing eye initially 50% between LogMAR 0 and LogMAR 0.60; the other 50% between LogMAR 0.70 and LogMAR 3. In the final visit, 60% had vision between LogMAR 0 to LogMAR 0.30. Clinical findings were variable, 100% patients showed mutton-fat keratic precipitates and anterior chamber reaction, followed by vitreitis in 60% of cases. 20 patients received Prednisolone drops, an at least 45% of cases received Methotrexate, Azathioprine or Cyclophosphamide. Finally, we encountered that 35.29% of our patient’s-inciting eye progressed to ptisis bulbi.
This study gives important information regarding epidemiology features of this pathology, and can be used as a tool to better understand this pathology, and therefore, develop new strategies for identification, prevention and give more effective treatments to this pathology, that has a lot to be discovered about. Our study has its limitations. We are dealing with a small number of patients in just one center. We had to exclude an important number of patients, because of missing data or incorrect diagnostic. And also, our criterion for selecting the patients with this disease lies on a presumptive diagnostic, not a histologic one. It is very important to continue investigating about this disease because little has been published in the literature. This study has special relevance for us, because it is the first report of characteristics in a series of cases of this pathology in Mexico.