Sympathetic ophthalmia in northern Thailand

Objective: To report on ocular manifestations and visual outcomes of Thai patients with sympathetic ophthalmia (SO). Materials and Methods: Medical records of 14 SO patients (nine males and five females) between 2006 and 2017 were retrospectively reviewed. Ocular manifestations, treatment modalities, complications, and visual outcomes were registered. Results: Ten patients (72%) had history of ocular trauma and four patients (28%) had history of intraocular surgery including glaucoma surgery (n=2) and scleral patch graft for perforated corneal ulcer (n=2). Five of inciting eyes (36%) were enucleated, but none within two weeks after initial trauma or surgery. Median time from initial trauma or surgery to development of SO was 1.75 years. In sympathizing eyes, the most common ocular manifestations were panuveitis (79%) with disc edema (71%) and exudative retinal detachment (57%). Ocular complications were seen in 82% of the patients and included glaucoma, cataract, and macular edema. Most of the patients were treated with systemic corticosteroids, and 36% of the patients received additional immunosuppressive agents. At the final visit, 71% of the patients maintained a visual acuity (VA) of 20/70 or better in their sympathizing eye, and none of the sympathizing eyes had VA of 20/200 or worse. Conclusion: Despite the high rate of ocular complications, most sympathizing eyes in Northern Thai patients with SO maintained good visual outcomes and only one third required additional immunosuppressive agents to control inflammation.