Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2009 Dec 20;122(24):2961-6.
Sympathetic ophthalmia (SO), a rare, bilateral, diffuse granulomatous uveitis, usually occurs after open globe injury or intraocular surgery. We sought to identify the risk factors for the development of SO after open globe injury and describe their demographic and clinical features and outcomes of treatments.
A retrospective study of inpatients with globe injury in 15 tertiary referral hospitals of China from January 2001 to December 2005 was conducted. The information of demography, nature and mechanism of injury, time and ways of treatments and outcomes was reviewed. Diagnosis of SO was made based on a history of ocular trauma or surgery and subsequent development of bilateral or contralateral uveitis consistent with SO. Any association between related parameters and development of SO was analyzed.
Among 9103 patients (9776 eyes) of globe injury, SO occurred after open globe injury in 18 cases with an occurrence rate of 0.37%, vitrectomy of closed globe injury in 2 (0.37%) and perforation of burned eyes in another 2. For open globe injury, the median age ((36.72 +/- 13.59) years, P = 0.01) was higher in patients with SO; there were no significant effects of sexes, injury type, uvea proplaps, once or multi-intraocular surgery, once or multi-vitrectomy and endophthalmitis on incidence of SO; 0.70% endophthalmitis concurred with SO; 83.33% of SO occurred within 1 year after injury or last ocular surgery. SO developed in a fellow eye one week after evisceration of the perforating burned eye. Good final visual acuity was obtained in sympathizing eyes with prompt treatment.
For open globe injuries, SO sufferers were relatively older and any injury type could induce SO with equal possibility. The initial open globe injury was more likely to be the trigger of SO than subsequent intraocular surgeries including vitrectomy. Prophylactic enucleation after injury is not recommended.
交感性眼炎（SO）是一种罕见的双侧弥漫性肉芽肿性葡萄膜炎，通常发生在开放性眼球损伤或眼内手术后。我们试图确定开放性眼球损伤后发生 SO 的危险因素，并描述其人口统计学和临床特征以及治疗结果。
对 2001 年 1 月至 2005 年 12 月在中国 15 家三级转诊医院住院的眼球损伤患者进行回顾性研究。回顾了人口统计学、损伤性质和机制、治疗时间和方式以及治疗结果的信息。根据眼部创伤或手术史以及随后发生的双侧或对侧葡萄膜炎与 SO 一致的病史，做出 SO 的诊断。分析了相关参数与 SO 发生之间的任何关联。
在 9103 例（9776 只眼）眼球损伤患者中，18 例（0.37%）发生开放性眼球损伤后发生 SO，2 例（0.37%）发生闭合性眼球损伤玻璃体切除术，另 2 例（0.37%）发生烧伤眼穿孔。对于开放性眼球损伤，SO 患者的中位年龄（（36.72+/-13.59）岁，P=0.01）较高；性别、损伤类型、葡萄膜膨出、一次或多次眼内手术、一次或多次玻璃体切除术和眼内炎对 SO 发生率无显著影响；0.70%的眼内炎并发 SO；83.33%的 SO 发生在损伤或最后一次眼部手术后 1 年内。在穿透性烧伤眼眼球摘除后一周，对侧眼发生了 SO。及时治疗后，同情眼中获得了良好的最终视力。
对于开放性眼球损伤，SO 患者年龄相对较大，任何类型的损伤都有可能导致 SO。初始开放性眼球损伤比随后的眼内手术（包括玻璃体切除术）更有可能成为 SO 的触发因素。受伤后不建议预防性眼球摘除。
