47例交感性眼炎激发眼临床资料分析

目的：探讨发生交感性眼炎的相关因素。方法：对47例交感性眼炎激发眼临床与病理资料进行回顾性分析，包括性别、年龄、眼别、致伤原因、受伤部位、潜伏期及病理改变等。结果：交感性眼炎多发生于青壮年，致伤原因多为眼球穿孔伤，受伤部位为角巩膜缘者最多，潜伏期在2～8周最多。病理改变以脉络膜从前向后的逐渐增厚为特征。结论：交感性眼炎的发生与年龄、受伤部位有关。交感性眼炎的病理学检查对交感性眼炎的诊断有指导意义。     

交感性眼炎的临床分析

本文分析了１９８０￣１９９３年收治的交感性眼炎３１例，由眼球穿通伤引起者３０例，占同期收治的眼球穿通伤１３０４３例的０．２３％，其中眼球破裂伤引起者１１例，在同期眼球破裂伤中占６．１２％；白内障手术引起者１例，在同期内眼手术占０．０３％。潜伏期１０天￣１５天。２月发病者占５８．０２％；３月以内发病者６７．７４％；６月以内发病者７７．４０％。还分析了致伤原因、受伤部位、临床表现、治疗及预后，讨论了发     

眼内炎50年后发生交感性眼炎一例

交感性眼炎的发病率国外统计占非手术性穿通伤的0.2～1％,国内统计占眼穿通伤的1～2％。交感性眼炎的潜伏期,最短的为10天;最长达40年。近来有人统计61％的病人发生在受伤眼后的3周～2个月之间,90％发生在1年之内。我们在1988年收治1例潜伏期达50年之久,现报告如下:     

交感性眼炎30例临床分析

目的探讨交感性眼炎的治疗及预防方法。方法回顾分析30例交感性眼炎的年龄、性别、致伤原因、受伤部位、潜伏期、发生率、临床表现、治疗及预后,讨论交感性眼炎发病机制、环磷酰胺疗效、摘除伤眼问题及预防方法。结果伤口24小时以内修复的眼球穿孔伤和同期内眼手术发生交感性眼炎22例,复发4例,复发率18.18%;伤口24小时以后修复及未修复的眼球穿孔伤发生交感性眼炎8例,复发4例,复发率50%。二者之间无显著差异(χ2=3.04 P>0.05)。交感性眼炎发生后再摘除伤眼者既不能缩短病程,也不能防止复发。应用皮质类固醇、环磷酰胺等药物治疗,炎症控制,视力均提高。结论及时准确处理伤眼及内眼手术可减少交感性眼炎的发生和复发,交感性眼炎发生后摘除伤眼要慎重选择适应证,联合应用环磷酰胺、皮质类固醇药物治疗效果较好。     

交感性眼炎52例临床分析

目的探讨交感性眼炎的发病机制、诊断及治疗方法。方法回顾性分析52例交感性眼炎的临床资料。结果交感性眼炎致伤物多种多样,眼球穿孔分别位于睫状区巩膜、角巩膜及角膜缘。病变部位以眼后段炎症为主者31例,占59．62％。外伤后发病时间最短15天,最长30年。人院时视力在0．1以下者32例,没有视力在1．0以上的病例,多数病人视力较差。经用糖皮质激素及免疫抑制剂治疗后视力恢复至0．2～0．9者14例,1．0及以上26例。视力存0．1以下者由32例减少至12例。视力较好和保留有用视力在0．2以上者共40例,占76．92％。结论穿孔性眼外伤可诱发交感性眼炎,尤其是眼球睫状区穿孔更为常见;用糖皮质激素或免疫抑制剂治疗本病取得了满意效果,说明交感性眼炎系自身免疫性疾病。     

交感性眼炎39例临床分析

近12年我院收治交感性眼炎39例，占同期眼科住院病人（13183例）、眼外伤（4650例）及眼穿通伤（4064例）住院病人的比率分别为0.3%、0.9%，其中眼异物伤3331例中发生交感性眼炎21例，占0.6%。男、女交感性眼炎患者之比36：3，分别占同期男、女眼外伤患者的0.9%和0.6%，经统计学处理，差异无显著性(P>0.05)。易发交感性眼炎的外伤部位多在角膜缘部和前巩膜及邻近组织。临床潜伏期多在20～60天之间。临床资料分析表明交感性眼炎的发生与受伤部位、手术处理状况和年龄等因素有关，而与性别和异物性质无关。 （中华眼底病杂志，1995，11：102-103）     

交感性眼炎

我院自1957年6月至1994年3月,37年间共收治交感性眼炎5例,占眼球穿孔伤住院病例的0.38%.其中1例伤眼化脓后发生交感性眼炎,采用发热疗法治愈,3例皮质类固醇疗程后加用发热疗法,病情稳定,随访2～18年,未见复发.一般资料:男4例,女1例,年龄20～36岁,右眼3例,左眼2例.金属异物致眼穿孔伤4例,拳击致眼球破裂伤1例.潜伏期短者22天,长者56天,眼前段病型1例,眼后段病型3例,全葡萄膜病型1例.伤后8天摘除化脓性伤眼1例,发生交感性眼炎后摘除刺激眼2例(病理证实),保留刺激眼2例.     

眼球穿孔伴化脓性眼内炎导致的交感性眼炎

目的：总结分析眼球穿孔伴化脓性眼内炎导致的交感性眼炎的临床特征、诊断及可能的发病原因。方法：对1993-2002年本院收治交感性眼炎87例中伴有化脓性眼内炎病史的交感性眼炎3例患者的临床资料作回顾性分析总结。结果：1993-2002年本院收治的眼球穿通伤及眼球破裂伤的病人5253例，同期收治的交感性眼炎87例，交感性眼炎的发生率为1．65％。其中3例发病前有眼球穿孔合并化脓性眼内炎的病史，3例眼底荧光血管造影检查结果均符合交感性眼炎改变；1例组织病理学检查报告为典型交感性眼炎改变。结论：眼球穿孔伴化脓性眼内炎仍可能发生交感性眼炎，应引起注意。眼科学报2003；19：75-78     

交感性眼炎22例临床分析

交感性眼炎是眼外伤的严重并发病,病因至今不明,伤后处理不当常诱发本病。本病发病后治疗不当常导致失明。现将我们所见的22例,作一简略的分析。 22例以男性21/48岁及工、农多见,分别占77.27%,72.73％,72.73％。致伤物:以后屑伤最多见,占40.91%。致伤部位:以睫状体区穿孔伤最多见,占77.27%伤后处理情况:以色素膜嵌置伤口,未妥善处理者发病最多见,占54.55%。潜伏期:以伤后14—6天发病最多见,占63.64%。治疗:均采用中西医综合疗法,其中4例以牛奶发热疗法为主,18例以皮质类固醇和血管扩张剂为主。交感眼治疗前后的视     

交感性眼炎30例临床分析

目的:了解该病发生的危险因素,为其基础研究方向提供有价值的资料。方法:对30例交感性眼炎进行回顾,分析交感性眼炎发生率、诱因、和损伤部位的关系、临床特点以及治疗的效果。结果:交感性眼炎占同期住院病人的0.72％,该病多发生于伤口位于角巩膜缘的眼球穿通伤,也见于内眼手术后、挫伤、肿瘤等情况,表现为全葡萄膜炎的占了63.3％。女性发病率高于男性。结论:交感性眼炎的发生和眼球正常结构的破坏有关并具有一定的组织特异性,交感性眼炎的发生率、该病与遗传的关系以及色素蛋白抗原与交感性眼炎的关系值得进一步深入研究。眼科学报1996;12:191～192。     

Cataract surgery in sympathetic ophthalmia

PURPOSE: To analyze the results of cataract surgery in patients with sympathetic ophthalmia. SETTING: Sankara Nethralaya, Medical Research Foundation, Chennai, India. METHODS: This study comprised 66 patients (132 eyes) with sympathetic ophthalmia seen at the uveitis referral clinic between January 1990 and July 2001; 42 eyes (31.8%) had cataract. Cataract surgery was performed in 17 sympathizing eyes and 1 exciting eye (17 patients). The records of these 18 eyes were retrospectively analyzed. Three eyes had extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation, 6 eyes had ECCE without IOL implantation, and 9 eyes had phacoemulsification with IOL implantation. The mean follow-up was 28.7 months (range 3 to 60 months). RESULTS: The causes of sympathetic ophthalmia were penetrating trauma (n = 8 eyes), ocular surgery (n = 6), perforated corneal ulcer (n = 2), and cyclocryotherapy (n = 1). The most common cataract type, present in 7 eyes (38.8%), was mixed (posterior subcapsular and posterior polar). Visual acuity improved after surgery in 13 eyes (72.2%). The main factors impairing visual recovery were submacular scar and optic atrophy, which were sequelae of the sympathetic ophthalmia. Posterior capsule opacification was noted in 14 eyes (77.7%); it was visually significant in 6 eyes. There was no significant difference in postoperative inflammation or disease reactivation between the 3 types of surgery. CONCLUSIONS: Cataract extraction in cases of sympathetic ophthalmia can be safely and successfully performed with vigilant preoperative and postoperative control of inflammation, careful surgical planning, and meticulous surgical technique. The final visual outcome, however, depends on the posterior segment complications of the disease.     

Ophthalmia neonatorum in northern Norway. I: Epidemiology and risk factors.

During one year, 1928 of all 1958 neonates born in the county of Troms in Northern Norway were followed until 6 weeks of age, regarding the development of ophthalmia neonatorum. Conjunctivitis was found in 364 cases (189 per 1000 neonates), including mild and self-limiting cases. In 14.5 cases per 1000 neonates the ophthalmia neonatorum was recorded as severe. Boys were more often affected than girls (P = 0.001). The age of the mother and obstetric events did not significantly influence the occurrence of conjunctivitis. 31.4% of the neonates received silver nitrate instillation. The frequency of conjunctivitis in the group with and without prophylaxis was 15.9 and 20.3%, respectively (P = 0.023). The incidence of chlamydial ophthalmia was 8 per 1000 neonates. At present, chlamydial ophthalmia is a common disease in neonates. Efforts should be made to screen fertile women for chlamydial genital infection and to encourage prompt microbiological examination in cases of ophthalmia neonatorum.     

玻璃体切除术后交感性眼炎的临床分析

目的 分析玻璃体切除术后交感性眼炎的临床特征.方法 回顾性分析璃体切除术后交感性眼炎13例的临床资料.结果 发生交感性眼炎的时间距最后一次玻璃体手术时间为10 d～2年,4个月以内者8例（61.5％）,临床表现以视力下降为主,其次为眼痛、眼前黑影、视物变形.发病时交感眼视力为0.04 ～0.6,激发眼视力为无光感～数指.4例交感眼有渗出性视网膜脱离.所有患者经糖皮质激素治疗后交感眼和激发眼视力均有不同程度恢复.3例因激发眼视力完全丧失而行眼球摘除术.结论 玻璃体切除术后交感性眼炎发生率为0.29％;大多发生在手术后4个月以内;术中联合晶状体手术、巩膜外冷凝、术前存在眼外伤和其它手术史,增加发生交感性眼炎的危险.     

玻璃体手术后交感性眼炎的临床及病理学观察

目的观察玻璃体手术后交感性眼炎的临床特点及病理学改变。方法回顾性分析1998年1月至2004年12月期间13000例玻璃体手术后8例交感性眼炎患者的临床资料，并对其中3例摘除的诱发眼进行了病理学观察。结果交感性眼炎的发生率为0.06%。发生交感性眼炎的时间距最后一次玻璃体手术的时间为7~150 d，平均时间为(77.8±50.8) d。主要表现为交感眼视力下降、视物变形，眼红，眼痛。发病时交感眼视力为手动~0.5，诱发眼视力为无光感~0.04。双眼羊脂状角膜后沉着、前房闪辉及细胞、玻璃体混浊、视盘水肿充血、后极部视网膜水肿，2例交感眼有渗出性视网膜脱离。所有患者经口服泼尼松1.0~1.5 mg/kg治疗后交感眼和诱发眼视力均有不同程度恢复。3例患者因诱发眼视力丧失行眼球摘除手术。被摘除的诱发眼病理检查表现为葡萄膜弥漫性淋巴细胞浸润增厚，类上皮细胞结节形成，淋巴细胞浸润巩膜孔道，眼球萎缩。结论玻璃体手术后交感性眼炎发生率为0.06%；大多数发生在手术后3个月内；其临床表现及病理学检查符合交感性眼炎的特征。（中华眼底病杂志，2007，23：112-114）     

Incidence of sympathetic ophthalmia after penetrating eye injury and choice of treatment

Introduction: Sympathetic ophthalmia, a diffuse bilateral granulomatous panuveitis, is a serious potential complication after penetrating eye injury. Many surgeons recommend enucleation within two weeks of trauma to prevent this condition. We retrospectively reviewed the medical records of patients with penetrating ocular injuries who had either evisceration or enucleation to determine the incidence of sympathetic ophthalmia and to evaluate the surgical interventions and their complications. Age at surgery, time after penetrating trauma, surgery technique, follow-up period, ophthalmic examination of the fellow eye, and surgical complications were evaluated. Results: In total, 217 patients were included in the study with a mean follow-up period of 10.3 ± 6.6 years. The longest time between the trauma and time of surgery was 43 years. Postoperative uveitis was observed in only one patient (0.5%) who had primary repair after injury. Histopathological review did not reveal typical sympathetic ophthalmia. Complications after enucleation were significantly higher than after evisceration. Conclusion: There was no histopathologically supported sympathetic ophthalmia in our series. Sympathetic ophthalmia is very rare even when the injured eye is retained. With this in mind, the first choice of treatment may not be enucleation. Furthermore, evisceration may be the procedure of choice if primary repair cannot be performed or for patients who have panophthalmitis.     

Sympathetic Ophthalmia after Vitreoretinal Surgeries: Incidence,Clinical Presentations and Outcomes of a Rare Disease

Aim: To evaluate clinical presentation, course and outcomes in patients without a history of penetrating ocular trauma who developed Sympathetic Ophthalmia (SO) following vitreoretinal surgeries

Methods: Retrospective review of clinical records of all patients diagnosed and treated as S.O was done . All cases without a previous history of trauma were included and were analyzed with respect to clinical presentations, anatomic and visual outcomes.

Results: 175 cases of sympathetic ophthalmia were diagnosed and treated till June 2017. 16 of these cases had undergone a pars plana vitrecomy (PPV) in the past and had no history of prior ocular trauma. SO after vitreoetinal surgeries accounted for 9.14 percent of all cases of SO .In the same duration, till 2017,a total 41365 PPV were done. Thus 0.038 percent of PPV cases developed a SO . 10 patients were males and 6 were females. The median age at presentation was 45.7 years. The time interval from surgery to diagnosis of sympathetic ophthalmia ranged from 22 days to 4 years after undergoing a surgery. The mean visual acuity in the sympathizing eye was 1.26 logMAR (snellens equivalent of 20/320) which improved to 0.62 logMAR(snellens equivalent of 20/80) after treatment. The most common anterior segment finding was non granulomatous anterior uveitis, seen in 8 cases (50%) while neurosensory detachments were the most common posterior segment presentation (10 cases, 62.5%).12 patients had undergone more than 1 surgery (mean number of surgeries was 1.88). 10 patients had undergone a sutureless PPV (6 cases of 23 gauge and 4 cases of 25 gauge vitrectomy) while 4 patients had undergone a 20 gauge vitrectomy where all sclerotomies were sutured after surgery All patients were treated with systemic steroids and immunosuppresants and 15 out of 16 patients showed significant improvement in the final visual acuity in the sympathizing eye

Conclusions: Sympathetic ophthalmia after vitreoretinal surgeries is a rare but potentially sight threatening disease occurring in 0.038 percent of all cases of Pars Plana Vitrectomy. Presence of inflammation in the fellow eye after a vitreoretinal surgery in the other eye should alert the surgeon to possibility of sympathetic ophthalmia     

Sympathetic ophthalmia

The authors give an account of a case of sympathetic ophthalmia which was successfully managed by reoperation of the injured eye, corticoids and immunosuppressive drugs. Sympathetic ophthalmia developed after perforation of the cornea along with traumatic cataract one month following the accident. It was manifested by irritation of the anterior segment of both eyes and marked exudation into the area of the posterior pole of the sympathizing eye. On the injured eye surgical reconstruction of the anterior segment was performed and concurrently broad spectrum antibiotics and corticoids were administered. On this therapy the anterior segment of both eyes began to improve, while the exudation into the area of the posterior pole of the sympathizing eye proceeded; therefore immunosuppressive therapy was started. The manifestations of sympathetic ophthalmia receded gradually. After an alternative way of corticoid reduction was started, a relapse of sympathetic ophthalmia occurred. The relapse was suppressed by a temporary increase of the dosage. Three months after the development of sympathetic ophthalmia, using the treatment described, the uveal inflammation of both eyes receded. At present, two years after the accident, both eyes are in a satisfactory condition with normal visual acuity--on the injured eye with an aphakic correction.     

High incidence of sympathetic ophthalmia after contact and noncontact neodymium:YAG cyclotherapy.

BACKGROUND: Two cases of sympathetic ophthalmia occurring after noncontact neodymium:YAG (Nd:YAG) cyclotherapy have previously been reported. In each case, the patient had undergone filtering surgery in the exciting eye. Although in each case Nd:YAG cyclotherapy was the last surgery performed, the inciting event of sympathetic ophthalmia was unclear. METHODS: The authors studied three additional patients who developed sympathetic ophthalmia after Nd:YAG cyclotherapy for glaucoma. RESULTS: Two patients developed sympathetic ophthalmia 4 months after noncontact Nd:YAG cyclotherapy, and 1 patient developed sympathetic ophthalmia 18 months after contact Nd:YAG cyclotherapy. All patients had previous cataract extractions but no filtering surgery in the exciting eye. Clinical features included chronic iridocyclitis, choroidal folds, Dalen-Fuchs nodules, and optic disc edema. Combining these cases with the two previously reported cases, the incidence of sympathetic ophthalmia at our institution thus far is 5.8% (4 of 69) and 0.67% (1 of 150) after noncontact and contact Nd:YAG cyclotherapy, respectively. CONCLUSIONS: The incidence of sympathetic ophthalmia after Nd:YAG cyclotherapy is high compared with other ocular procedures. The clinician should vigilantly monitor patients after Nd:YAG cyclotherapy and report additional cases that may have occurred at other institutions.