Sympathetic Ophthalmia in Patients with Enucleation or Evisceration: Pathology Laboratory and IRIS
Publication/Presentation Date
12-1-2023
Abstract
INTRODUCTION: Sympathetic ophthalmia (SO) is a rare bilateral granulomatous panuveitis that can follow surgical or nonsurgical ocular trauma in one eye. Because its diagnosis requires clinical-pathologic correlation, the true incidence of SO is unknown, and there is a need to understand the recent trends in risk factors and frequency of this condition.
METHODS: Pathology records of all enucleated or eviscerated (ENEV) eyes at three pathology laboratories were reviewed. Data collected included patient demographics, procedure indication, pathology diagnosis, and clinical history of trauma and uveitis. IRIS
RESULTS: In the pathology laboratory setting, the incidence of SO over a 36-year period in patients who underwent ENEV was 0.2% (20/9,092); the 5-year incidence ranged from 0.0 to 0.3%. Among the 20 eyes with SO, the inciting event was surgical trauma in 50% (10/20), nonsurgical trauma in 45% (9/20), and missing/undetermined in 5% (1/20). SO was suspected preoperatively in 7/20 (35%) patients. Clinical concern for SO and ruptured globe were indications for ENEV in 50/9,092 (0.5%) and 872/9,092 (10%) patients, respectively. In the IRIS Registry, 0.7% (199/27,830) of patients with AAE/ENEV had diagnosis of SO. The frequency of SO between 2015 and 2020 was 0.01% (7,371/62,318,249); of these 7,371 cases, 199 (3%) had AAE/ENEV. In 25,975 patients with available data, injury and SO were listed as diagnoses less than 30 days prior to AAE/ENEV in 909 (4%) and 63 (0.2%) cases, respectively.
CONCLUSION: The frequency of SO in recent decades has been low. Most cases of SO are not managed with eye removal. In histopathology-confirmed SO, surgical trauma is as frequent as nonsurgical trauma as an inciting etiology of disease.
Volume
9
Issue
5-6
First Page
138
Last Page
151
ISSN
2296-4681
Published In/Presented At
Bui, K., Tomaiuolo, M., Carter, K., Iacob, C., Neerukonda, V., Stagner, A., Sajjadi, Z., Escobar, K. V., Ordoñez Armijos, P., Eagle, R. C., Mehta, S., Dunn, J. P., Hyman, L., Milman, T., & IRIS Registry Analytic Center Consortium (2023). Sympathetic Ophthalmia in Patients with Enucleation or Evisceration: Pathology Laboratory and IRIS® Registry Experience. Ocular oncology and pathology, 9(5-6), 138–151. https://doi.org/10.1159/000533310
Disciplines
Medicine and Health Sciences
PubMedID
38089175
Department(s)
Department of Surgery
Document Type
Article