Spectral-domain optical coherence tomography of sympathetic ophthalmia with Dalen-Fuchs nodules.

The authors present a case of sympathetic ophthalmia with Dalen-Fuchs nodules visualized with spectral-domain optical coherence tomography (SD-OCT). An 84-year-old man presented with floaters and decreased vision 25 years after penetrating trauma to the fellow eye. Examination revealed vitritis and subretinal lesions consistent with Dalen-Fuchs nodules. He was diagnosed with sympathetic ophthalmia after a negative systemic work-up. SD-OCT revealed hyper-reflective lesions at the level of the retinal pigment epithelium with disruption of the inner segment/outer segment (IS/OS) junction. Treatment resulted in clinical improvement and disappearance of Dalen-Fuchs nodules on SD-OCT; however, photoreceptor and retinal pigment epithelial disruptions persisted 5 months after treatment was initiated.