Sympathetic Ophthalmia Presented as Uncontrolled Intraocular Pressure Elevation- A Case Report
Accept poster if oral is not possible ?
Yes
Purpose
To report a case of sympathetic ophthalmia presented as uncontrolled intraocular pressure.
Methods
Case report.
Results
We report a case of a 67-year-old Taiwanese female with a previous systemic history of hypertension. She received pars plana vitrectomy with silicone oil temponade in her left eye due to foveaschisis. However, post-operative endophthalmitis occurred complicated with severe orbital cellulitis and she lost the vision of her left eye. Floaters developed in her left eye six months after her right eye infection silent down. Elevated intraocular pressure (IOP) up to 37mmHg was noted with mild vitreious cells (1+). Topical steroid (Pred forte, 1% prednisolone acetate) was given four times a day. IOP lowering agents were added in order during a period of 1 months, however, IOP still could not be controlled well (more than 30mmHg) after a combination of Cosopt (dorzolamide 20mg/ml and timolol 5mg/ml, every 8 hours), xalatan (latanoprost 50ug/ml, one a day) and oral acetazolamide (250mg. four times a day). Aqueous humor was collected for herpes simplex virus, cytomegalovirus and varicella-zoser virus polymerase chain reaction tests but showed negative results. Oral prednisolone 45mg per day was started according to patient’s body weight (45kg). IOP became controllable and oral prednisolone was tapered gradually. IOP elevation noted again while oral prednisoloe tapered to 5mg per day. Immunomodulatory therapy was considered and myfortic (mycophenolate mofetil 720mg two times a day) was added. Her IOP than can be controlled well.
Conclusion
IOP elevation can be the only and main symptom and sign of sympathetic ophthalmia, which may need immunomodulatory therapy to achieve good control.
Conflict of interest
No
1
Last name
LIANG
Initials of first name(s)
C
Department
Ophthalmology Dpt, Tri-Service Gen. Hospital, Nat. Defense Medical Center, Cathay Gen.l Hospital
City
Taipei
Country
Taiwan
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