Leal Inês, Sousa David Cordeiro, Loureiro Cláudia, Fonseca Ana
Department of Ophthalmology, Hospital de Santa Maria; Visual Sciences Study Center, CECV, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Department of Ophthalmology, Vila de Franca de Xira Hospital, Lisbon, Portugal.
Indian J Ophthalmol. 2017 Aug;65(8):741-743. doi: 10.4103/ijo.IJO_983_16.
Sympathetic ophthalmia (SO) is a rare, diffuse, bilateral, and granulomatous nonnecrotizing panuveitis that may follow intraocular penetrating trauma. Our aim is to report a rare case of SO following orbital exenteration. Orbital exenteration was performed on a 48-year-old african female due to conjunctival keratinizing squamous cell carcinoma with intraocular involvement of the left eye. Five days after the uneventful procedure, the patient presented signs and symptoms compatible with SO. Key differential diagnoses were excluded, and prompt and aggressive immunosuppression was started with a favourable but slow clinical response. This case highlights the fact that SO can also be induced by a neoplasm with intraocular invasion or by aggressive nonpenetrating surgery. While the underlying pathogenesis of SO is still not fully elucidated, we hereby contribute with a novel potential mechanism leading to its development.
交感性眼炎(SO)是一种罕见的、弥漫性的、双侧性的、肉芽肿性非坏死性全葡萄膜炎,可继发于眼内穿透性外伤。我们的目的是报告一例眶内容剜出术后发生交感性眼炎的罕见病例。一名48岁的非洲女性因结膜角化鳞状细胞癌伴左眼眼内受累而接受了眶内容剜出术。在手术顺利完成五天后,患者出现了与交感性眼炎相符的体征和症状。排除了主要的鉴别诊断后,立即开始积极的免疫抑制治疗,临床反应良好但进展缓慢。该病例突出了一个事实,即交感性眼炎也可由眼内侵犯的肿瘤或激进的非穿透性手术诱发。虽然交感性眼炎的潜在发病机制仍未完全阐明,但我们在此提出了一种导致其发生的新的潜在机制。