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Review Article

Long-Term Drug-Free Remission and Visual Outcomes in Sympathetic Ophthalmia

, MBBS, MPH & , MD, FACS
Pages 190-195 | Received 17 Mar 2015, Accepted 31 Aug 2015, Published online: 25 Jan 2016
 

ABSTRACT

Purpose: To assess corticosteroid- and immunosuppressive therapy (IST)-free long-term remission in the treatment of patients with sympathetic ophthalmia (SO), a vision-robbing disease that can span a lifetime.

Methods: The medical records of 19 patients with SO aged 16.1 to 94.95 years (median age 58.56 years) with median follow-up of 7.10 years (mean, 6.41; range, 2.5 to 8.63 years) were retrospectively examined.

Results: All patients achieved control of inflammation, 13 of them for 2 years or more. Three (15.78%) of the 19 patients maintained remission without IST and corticosteroids for more than 5 years with vision of 20/25 or better in the sympathizing eye. Thirteen patients (68.42%) were inactive on IST or corticosteroids or in combination therapy. Eleven patients (57.9%) maintained visual acuity of 20/40 or better at the end of follow-up.

Conclusion: Even with a devastating and possibly lifelong disease like sympathetic ophthalmia, long-term remission off all IST and corticosteroids, and perhaps even cure, is possible.

ACKNOWLEDGMENTS

The authors thank Abhishek Payal, MBBS, MPH for independent statistical analysis.

DECLARATION OF INTEREST

Dr. C. Stephen Foster declares the following: Consultancies with Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA), Eyegate Pharma (Waltham, MA), Novartis (Cambridge, MA), pSivida (Watertown, MA), and Xoma (Berkeley, CA). Grants or grants pending with Alcon (Aliso Viejo, CA), Aldeyra Therapeutics (Lexington, MA), Bausch & Lomb (Bridgewater, NJ), Clearside Biomedical (Alpharetta, GA), Dompé pharmaceutical (Milan, Italy), Eyegate Pharma (Waltham, MA), Mallinckrodt pharmaceuticals (Dublin, Ireland), Novartis Pharmaceuticals (Cambridge, MA), pSivida (Watertown, MA), Santen (Osaka, Japan). Payment for lectures including service on speaking bureaus: Alcon (Aliso Viejo, CA), Allergan (Dublin, Ireland). Stock or Stock Options: Eyegate Pharma (Waltham, MA).

All other authors certify they have nothing to declare.

Additional information

Notes on contributors

Abhishek R. Payal

AP and CSF contributed to the conception, design, acquisition of data and drafting this article. CSF was responsible for critically reviewing the intellectual content of the article. All authors read and approved the final manuscript.

C. Stephen Foster

AP and CSF contributed to the conception, design, acquisition of data and drafting this article. CSF was responsible for critically reviewing the intellectual content of the article. All authors read and approved the final manuscript.

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