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Presentation preference Oral
review resultOffer poster
TitleOCT as a tool to detect early sympathetic ophthalmia in an asymptomatic patient
Accept poster if oral is not possible ?Yes
PurposeSO 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.
MethodsChart review. Histopathological examination of the enucleated eye.
Ophthalmological evaluation, macular SD-OCT and fluorescein angiography (FA), over a 6 month period.
ResultsA 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.
ConclusionCurrently, 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 interestNo
Author 1
Last nameKHAN
Initials of first name(s)Z
Author 2
Last name Aubin
Initials of first name(s)M