A rare entity: Sympathetic ophthalmia presumably after blunt trauma to the phthisical eye and optical coherence tomography angiography metrics to monitor response to treatment

Khatri, Anadi; Timalsena, Satish; Khatri, Bal Kumar; Kharel, Muna; Gautam, Sudhir; Gurung, Jeena; Kafle, Santosh Upadhyaya

doi:10.1002/ccr3.2597

Cited by 10 publications

(9 citation statements)

References 19 publications

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“… 17 , 18 , 19 , 20 In our previous report of a sympathetic ophthalmia which had a similar clinical features in the posterior segment, we had expressed how choroidal thickness and its vasculature pattern/architecture analysis using OCTA could be helpful in monitoring the disease progression. 21 The same imaging technique was found to be important in the management of this caseas well. This,we believe, further adds to the evidence that OCTA of the retina and the choroid and choroidal thickness have the potential to be used as vital indicators in monitoring the pathologies of the uvea and retina.…”

Section: Discussionmentioning

confidence: 62%

Post typhoid fever neuroretinitis with serous retinal detachment and choroidal involvement-A case report

Khatri

Wagle

Hony

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose To report post typhoid fever neuroretinitis with Serous Retinal Detachment and choroidal involvement. Observation Patients with diminished vision post typhoid fever can present with neuroretinitis with serous retinal detachment. Conclusion and importance With help from noninvasive imaging such as optical coherence tomography angiography(OCTA) and Deep Range Imaging(DRI), we were able to conclude choroidal involvement – which has not been discussed in literatures yet.OCTA and choroidal thicknessboth served as agood indicators for monitoring the response of treatment in this case.

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Section: Discussionmentioning

confidence: 62%

Post typhoid fever neuroretinitis with serous retinal detachment and choroidal involvement-A case report

Khatri

Wagle

Hony

et al. 2021

American Journal of Ophthalmology Case Reports

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“…OCTA has also been useful in choroidal imaging as described in a case of sympathetic ophthalmia.OCTA of the choroidal vascular revealed flow void pockets initially at inflammatory stage, and this normalized over time into typical granular pattern after initiation of the treatment 25 .…”

Section: Discussionmentioning

confidence: 95%

Optical coherence tomography angiography (OCTA) of retinal vasculature in patients with post fever retinitis: a qualitative and quantitative analysis

Sanjay

Gadde

Agrawal

et al. 2021

Sci Rep

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Post fever retinitis is a heterogenous entity that is seen 2–4 weeks after a systemic febrile illness in an immunocompetent individual. It may occur following bacterial, viruses, or protozoal infection. Optical coherence angiography (OCTA) is a newer non-invasive modality that is an alternative to fundus fluorescein angiography to image the retinal microvasculature. We hereby describe the vascular changes during the acute phase of post fever retinitis on OCTA. Imaging on OCTA was done for all patients with post fever retinitis at presentation with 3 × 3 mm and 8 × 8 mm scans centred on the macula and corresponding enface optical coherence tomography (OCT) scans obtained. A qualitative and quantitative analysis was done for all images. 46 eyes of 33 patients were included in the study. Salient features noted were changes in the superficial (SCP) and deep capillary plexus (DCP) with capillary rarefaction and irregularity of larger vessels in the SCP. The DCP had more capillary rarefaction when compared to the SCP. The foveal avascular zone (FAZ) was altered with an irregular perifoveal network. Our series of post fever retinitis describes the salient vascular features on OCTA. Although the presumed aetiology was different in all our patients, they developed similar changes on OCTA. While OCTA is not useful if there is gross macular oedema, the altered FAZ can be indicative of macular ischemia.

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“…However, there has been no report of complete disinsertion of iris in an intact globe as its cause in the current literature. Another relevant case report by Khatri et al described a case of sympathetic ophthalmia caused by a blunt trauma to the phthisical eye, which suffered a penetrating eye injury 17 years back [ 17 ]. The authors suggested that damage to certain uveal tissues may itself be sufficient to trigger an immune response and a penetrating trauma may not be a prerequisite for the development of sympathetic ophthalmia [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another relevant case report by Khatri et al described a case of sympathetic ophthalmia caused by a blunt trauma to the phthisical eye, which suffered a penetrating eye injury 17 years back [ 17 ]. The authors suggested that damage to certain uveal tissues may itself be sufficient to trigger an immune response and a penetrating trauma may not be a prerequisite for the development of sympathetic ophthalmia [ 17 , 18 ]. Our case report supports this hypothesis and indeed, sympathetic ophthalmia has also been reported in association with keratitis [ 4 , 5 ], chemical burns [ 2 ], and insect sting [ 19 ], in the absence of penetrating eye injury or any intraocular procedures.…”

Section: Discussionmentioning

confidence: 99%

An Atypical Presentation of Sympathetic Ophthalmia in an Intact Globe Following Mechanical Fall: A Case Report and Literature Review

Chean

Lim

Kumar

et al. 2021

Vision

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Purpose: To describe an atypical case of sympathetic ophthalmia presenting after blunt trauma causing disinsertion of the iris in an intact globe. Methods: Case report. Results: A 71-year-old lady presented to the Emergency Department following a mechanical fall. On examination, she was noted to have periocular haematoma, subconjunctival haemorrhage, hyphaema, and vitreous haemorrhage in the left eye, but there was no evidence of globe rupture. The presenting visual acuity was 6/18. As the hyphaema and vitreous haemorrhage settled, a complete loss of the iris was noted with normal fundus. She was re-admitted a month later under the medical team with urinary tract infection and reduced vision in both eyes. On examination, there was mild conjunctival injection, keratic precipitates, anterior chamber flare, 180-degree posterior synechiae, and vitritis with no fundal view of the right eye. She was diagnosed with sympathetic ophthalmia and was treated with topical and systemic corticosteroid. Her vision improved gradually with treatment and was stable at 6/6 on the right (sympathising) eye and 6/9 on the left (excited) eye at final follow-up. Conclusion: Sympathetic ophthalmia may result from non-penetrating ocular trauma. Comprehensive history of mechanism of injury and ophthalmic examination is essential so that prompt treatment can be given to improve the visual prognosis of affected patients.

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A rare entity: Sympathetic ophthalmia presumably after blunt trauma to the phthisical eye and optical coherence tomography angiography metrics to monitor response to treatment

Cited by 10 publications

References 19 publications

Post typhoid fever neuroretinitis with serous retinal detachment and choroidal involvement-A case report

Post typhoid fever neuroretinitis with serous retinal detachment and choroidal involvement-A case report

Optical coherence tomography angiography (OCTA) of retinal vasculature in patients with post fever retinitis: a qualitative and quantitative analysis

An Atypical Presentation of Sympathetic Ophthalmia in an Intact Globe Following Mechanical Fall: A Case Report and Literature Review

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