OCT as a tool to detect early sympathetic ophthalmia in an asymptomatic patient
Purpose
SO typically comes to the attention of physicians after disease onset. This case is the first in which spectral-domain optical coherence tomography (SD-OCT) lead to diagnosing early SO in an asymptomatic patient.
Methods
Chart review. Histopathological examination of the enucleated eye.
Ophthalmological evaluation, macular SD-OCT and fluorescein angiography (FA), over a 6 month period.
Results
A 23 year-old male sustained penetrating ocular trauma to his left eye. Initial globe repair occurred within hours of the injury. He was referred to the Oculoplastics service at Maisonneuve-Rosemont Hospital (HMR) in Montreal, Canada, for a painful eye with no visual potential. Uneventful enucleation of the traumatized eye was performed. One month post-operatively, the patient was referred to an optometrist for fitting of protective lenses. Routine SD-OCT of the right eye revealed retinal pigment epithelium abnormalities. SD-OCT was repeated at HMR and revealed a small serous retinal detachment. FA showed a pinpoint leak and optic disc leakage in the late-phase. The patient was diagnosed with SO, and started on oral prednisone. The SD-OCT and FA abnormalities resorbed and at 6 months follow-up, ophthalmologic exam and imaging remained normal while solely on long-term Mycophenolate mofetil. Histo-lopathologic examination of the enucleated left eye demonstrated chorioidal inflammation thought to be compatible with a diagnosis of SO.
Conclusion
Currently, no guidelines exist for screening patients who sustained globe-penetrating injuries. Abnormalities on OCT can precede clinical findings of SO. SD-OCT screening for SO should be recommended every 2-4 months within the first year of trauma.
Conflict of interest
No
Author 1
Last name
KHAN
Initials of first name(s)
Z
City
Montreal
Country
Canada
Author 2
Last name
Aubin
Initials of first name(s)
M
City
Montreal
Country
Canada
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