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Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?

Sympathetic ophthalmia is a rare bilateral diffuse granulomatous panuveitis that usually results from surgical or penetrating trauma to one eye. The symptoms range from impaired near vision to pain, photophobia, and loss of visual acuity. Anterior segment manifestations include bilateral acute uveit...

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Autores principales: Paulbuddhe, Vivek, Addya, Sujit, Gurnani, Bharat, Singh, Dheerendra, Tripathy, Koushik, Chawla, Rohan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542579/
https://www.ncbi.nlm.nih.gov/pubmed/34707340
http://dx.doi.org/10.2147/OPTH.S289688
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author Paulbuddhe, Vivek
Addya, Sujit
Gurnani, Bharat
Singh, Dheerendra
Tripathy, Koushik
Chawla, Rohan
author_facet Paulbuddhe, Vivek
Addya, Sujit
Gurnani, Bharat
Singh, Dheerendra
Tripathy, Koushik
Chawla, Rohan
author_sort Paulbuddhe, Vivek
collection PubMed
description Sympathetic ophthalmia is a rare bilateral diffuse granulomatous panuveitis that usually results from surgical or penetrating trauma to one eye. The symptoms range from impaired near vision to pain, photophobia, and loss of visual acuity. Anterior segment manifestations include bilateral acute uveitis with mutton-fat keratic precipitates and posterior segment findings include vitritis, multifocal neurosensory retinal detachment, choroiditis, optic nerve edema, and Dalen–Fuchs nodules. The diagnosis is clinical. Ancillary investigations include fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT), ultrasound B scan, and autofluorescence imaging. The management options include corticosteroids (topical and systemic) as the first line along with immunomodulatory therapy started at the presentation of the disease. Recent advances include imaging with OCT-angiography, enhanced depth imaging-OCT (EDI-OCT, choroidal vascular index/CVI), targeting IL-23/IL-17 pathway, and use of biologics for the management of this rare entity. Recent advances in early diagnosis and prompt treatment has led to improved final visual outcomes in both the sympathizing and exciting eye. This review is aimed at giving a comprehensive overview of sympathetic ophthalmia along with a special emphasis on current treatment strategies and recent advances.
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spelling pubmed-85425792021-10-26 Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies? Paulbuddhe, Vivek Addya, Sujit Gurnani, Bharat Singh, Dheerendra Tripathy, Koushik Chawla, Rohan Clin Ophthalmol Review Sympathetic ophthalmia is a rare bilateral diffuse granulomatous panuveitis that usually results from surgical or penetrating trauma to one eye. The symptoms range from impaired near vision to pain, photophobia, and loss of visual acuity. Anterior segment manifestations include bilateral acute uveitis with mutton-fat keratic precipitates and posterior segment findings include vitritis, multifocal neurosensory retinal detachment, choroiditis, optic nerve edema, and Dalen–Fuchs nodules. The diagnosis is clinical. Ancillary investigations include fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT), ultrasound B scan, and autofluorescence imaging. The management options include corticosteroids (topical and systemic) as the first line along with immunomodulatory therapy started at the presentation of the disease. Recent advances include imaging with OCT-angiography, enhanced depth imaging-OCT (EDI-OCT, choroidal vascular index/CVI), targeting IL-23/IL-17 pathway, and use of biologics for the management of this rare entity. Recent advances in early diagnosis and prompt treatment has led to improved final visual outcomes in both the sympathizing and exciting eye. This review is aimed at giving a comprehensive overview of sympathetic ophthalmia along with a special emphasis on current treatment strategies and recent advances. Dove 2021-10-20 /pmc/articles/PMC8542579/ /pubmed/34707340 http://dx.doi.org/10.2147/OPTH.S289688 Text en © 2021 Paulbuddhe et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Paulbuddhe, Vivek
Addya, Sujit
Gurnani, Bharat
Singh, Dheerendra
Tripathy, Koushik
Chawla, Rohan
Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?
title Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?
title_full Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?
title_fullStr Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?
title_full_unstemmed Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?
title_short Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?
title_sort sympathetic ophthalmia: where do we currently stand on treatment strategies?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542579/
https://www.ncbi.nlm.nih.gov/pubmed/34707340
http://dx.doi.org/10.2147/OPTH.S289688
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