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Recent advances in diagnosis and management of sympathetic ophthalmia
- Source :
- Current Opinion in Ophthalmology. 32:555-560
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Purpose of review Sympathetic ophthalmia is a bilateral granulomatous uveitis that occurs following unilateral trauma or surgery and is sight-threatening in the contralateral eye. Despite significant potential morbidity, disease remains poorly understood. Variable presentations and clinical courses, as well as a lack of definitive diagnostic laboratory tests can complicate the diagnosis and result in delayed treatment, which can beget permanent vision loss. This review focuses on recent advances in areas of pathophysiology, classification, diagnosis and treatment. Recent findings Sympathetic ophthalmia is thought to involve a cell-mediated immune response to retinal and uveal antigens exposed through trauma or surgery. Multiple mechanisms have been implicated, including activation of the interleukin-23/IL-17 pathway. Ongoing emphasis is placed on early disease recognition and prompt treatment with multimodal imaging. Multiple authors advocate for the routine use of optical coherence tomography (OCT) for screening and disease monitoring. Systemic steroids and steroids sparing-immunosuppressive agents remain the mainstay of treatment. Summary Understanding pathophysiology may provide useful targets for drug development, as well as allow for identification of patients at risk. OCT is a useful tool in early diagnosis and management of sympathetic ophthalmia, as OCT changes may precede clinical symptoms and signs, allowing for early disease detection and better visual outcomes.
- Subjects :
- Multimodal imaging
medicine.medical_specialty
business.industry
Sympathetic ophthalmia
Early disease
Vision Disorders
General Medicine
Delayed treatment
Disease
Disease monitoring
medicine.disease
eye diseases
Uveitis
Ophthalmology
Drug development
Ophthalmia, Sympathetic
medicine
Humans
Diagnostic laboratory
Intensive care medicine
business
Immunosuppressive Agents
Tomography, Optical Coherence
Subjects
Details
- ISSN :
- 15317021 and 10408738
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Current Opinion in Ophthalmology
- Accession number :
- edsair.doi.dedup.....ed03dc5707183aae64e7541727555116