Título / Title

SYMPATHETIC OPHTHALMIA FOLLOWING PARS PLANA VITRECTOMY

Introdução / Purpose

To describe a case of sympathetic ophthalmia (SO) following vitrectomy.

Material e Método / Methods

A 26-year-old woman was admitted in an eye clinic with sudden vision loss in the right eye (OD). The patient underwent two surgical procedures in the contralateral eye in the previous two months for regmatogenic retinal detachment (pars plana vitrectomy, endolaser and introduction of C3F8 gas, and later phacoemulsification with intraocular lens implantation, retinopexy with band placement, pars plana vitrectomy with peeling of membrane, endolaser and silicone oil placement into the vitreous cavity). Two years earlier she was submitted to LASIK for high bilateral myopia correction, and laser in the peripheral retina.

Resultados / Results

At the examination had visual acuity in OD of 20/30 and hand movements in the left eye (OS), anterior chamber reaction 2+ with fine keratic precipitates in OD and flare in the anterior chamber of OS. Retinal fundus of the OD presented multiple areas of serous retinal detachment in the posterior pole associated with vitreous inflammation. The hypothesis of SO was based on the history of penetrating ocular trauma and on the absence of positive tests on the infectious (toxoplasmosis, syphilis, tuberculosis, HIV) and rheumatic screening. Treatment with oral prednisone 1 mg/kg/day was started followed by subsequent tapering, with improvement of fundoscopic findings 20 days following the beginning of the medication and associated visual acuity improvement (20/20 in the OD and 20/400 in the OS). Twelve months after the onset, the patient was followed without systemic medication, with persistent visual acuity, no inflammatory signs, and with bilateral retinal pigmented epithelium rarefaction.

Discussão e Conclusões / Conclusion

SO is a rare cause of uveitis, and the good prognosis depends on the prompt diagnosis and treatment. Since treatment is conducted with immunosuppressive medications, the exclusion of infectious diseases that can mimic this clinical condition is imperative.

Palavras Chave

uveitis, sympathetic ophthalmia, panuveitis