학술논문
Sympathetic Ophthalmia in Patients with Enucleation or Evisceration: Pathology Laboratory and IRIS ® Registry Experience.
Document Type
Academic Journal
Author
Bui K; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Tomaiuolo M; Ophthalmology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, PA, USA.; Carter K; Ophthalmology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Iacob C; Ophthalmology and Pathology Department, New York Eye and Ear Infirmary of Mount Sinai, Icahn School of Medicine, New York, NY, USA.; Neerukonda V; Ophthalmology and Pathology Department, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.; Stagner A; Ophthalmology and Pathology Department, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.; Sajjadi Z; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Escobar KV; Pathology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Ordoñez Armijos P; Pathology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Eagle RC; Pathology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Mehta S; Ophthalmology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Retina Service, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Dunn JP; Ophthalmology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Uveitis Service, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Hyman L; Ophthalmology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Vickie and Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, PA, USA.; Milman T; Ophthalmology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.; Pathology Department, Wills Eye Hospital, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Source
Publisher: S. Karger, Medical and Scientific Publishers Country of Publication: Switzerland NLM ID: 101656139 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2296-4681 (Print) Linking ISSN: 22964657 NLM ISO Abbreviation: Ocul Oncol Pathol Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2296-4681
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® Registry (Intelligent Research in Sight) was searched for all patients with SO, acquired absence of eye (AAE), and/or ENEV. Data obtained included patient demographics, ocular procedures, and preoperative diagnoses within 30 days of AAE/ENEV.
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.
Competing Interests: The authors have no conflicts of interest to declare.
(© 2023 S. Karger AG, Basel.)
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.
Competing Interests: The authors have no conflicts of interest to declare.
(© 2023 S. Karger AG, Basel.)