Su Daniel Hsien-Wen, Chee Soon-Phaik
Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore.
Graefes Arch Clin Exp Ophthalmol. 2006 Feb;244(2):243-7. doi: 10.1007/s00417-005-0009-4. Epub 2005 Jul 19.
Sympathetic ophthalmia (SO) is an uncommon uveitic condition that occurs after injury to the uvea of one eye and may occur after accidental ocular trauma or ocular surgery. We sought to investigate the common causes of SO in Singapore and the demographic profile as well as the final visual acuity after treatment in these patients.
This was a retrospective, non-comparative case series in which patients with SO were identified from the Singapore National Eye Centre uveitis database in the period between 1993 and 2003. The patients' case records were examined for a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO or histopathological evidence of SO in enucleated eyes. The medical records of these patients were reviewed for details of the inciting event, presentation, treatment, and visual acuity.
A total of ten patients (six men and four women) were diagnosed with SO in the period of study. SO occurred after accidental trauma in three patients and following ocular surgery in seven. Vitreoretinal surgery was responsible for four of these cases, and diode laser cyclophotoablation for another two, whereas neodymium:yttrium-aluminium-garnet (Nd:YAG) laser cyclotherapy was the cause in the last patient. Overall, six of ten patients underwent at least one vitreoretinal procedure. Four of the patients had a final visual acuity of 6/15 or better, whereas five had a visual acuity of 6/30 or worse. Good final visual acuity appeared to be associated with early initiation of immunosuppressive therapy.
In this series, ocular surgery, especially vitreoretinal surgery, had overtaken non-surgical trauma as the major cause of SO. A good outcome was possible in most cases if an early diagnosis was made and immunosuppressive treatment started promptly.
交感性眼炎（SO）是一种罕见的葡萄膜炎疾病，发生于一只眼睛的葡萄膜受伤后，可在意外眼外伤或眼科手术后出现。我们旨在调查新加坡SO的常见病因、患者的人口统计学特征以及这些患者治疗后的最终视力。
这是一项回顾性、非对照病例系列研究，从1993年至2003年期间新加坡国家眼科中心葡萄膜炎数据库中识别出SO患者。检查患者的病历，以了解眼外伤或手术史以及随后出现的与SO相符的双侧或对侧葡萄膜炎，或摘除眼球的组织病理学证据。回顾这些患者的病历，以获取诱发事件、临床表现、治疗和视力的详细信息。
在研究期间，共诊断出10例SO患者（6例男性，4例女性）。3例患者SO发生于意外创伤后，7例发生于眼科手术后。其中4例由玻璃体视网膜手术引起，2例由二极管激光睫状体光凝术引起，最后1例由钕：钇铝石榴石（Nd:YAG）激光睫状体光凝术引起。总体而言，10例患者中有6例至少接受了一次玻璃体视网膜手术。4例患者的最终视力为6/15或更好，而5例患者的视力为6/30或更差。良好的最终视力似乎与早期开始免疫抑制治疗有关。
在本系列研究中，眼科手术，尤其是玻璃体视网膜手术，已取代非手术创伤成为SO的主要病因。如果能早期诊断并及时开始免疫抑制治疗，大多数病例可能会有良好的预后。
