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Abstract
Purpose: To report pathologic changes in the conjunctiva from the exciting eye in a case of sympathetic ophthalmia (SO).
Methods: Report of clinical findings and conjunctival histopathology in a patient with SO.
Results: A 50-year-old male developed SO, with unusual peribulbar conjunctival pigmentation in the inciting eye. Histological examination of the conjunctival biopsy revealed perivascular distribution of CD68+ melanophages that also expressed HLA-DR, suggesting that these macrophages may act as antigen-presenting cells. In addition, increased CD4+ and CD3+ lymphocytes were noted in the subconjunctival space when compared to specimens of normal conjunctiva and traumatic uveal prolapse without SO, suggesting T-cell recruitment.
Conclusions: These pathologic findings suggest a possible mechanism by which local antigen processing by subconjunctival melanophages may play a role in the initiation of the complex cell-mediated response seen in SO.
ACKNOWLEDGMENT
This work was supported by the Summa Foundation, Akron, OH; Doris Semler, Arlington Heights, IL; and Research to Prevent Blindness, New York, NY (DAG).
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Dr. Goldstein is supported by an Unrestricted Grant from Research to Prevent Blindness, New York, NY.