International Ophthalmology

, Volume 4, Issue 3, pp 129–135 | Cite as

Atypical histopathologic features in sympathetic ophthalmia

A study of a hundred cases
  • Juan O. Croxatto
  • Narsing A. Rao
  • Ian W. McLean
  • George E. Marak


One hundred cases of clinically acceptable sympathetic ophthalmia (SO) were evaluated histologically to determine the incidence of atypical features and correlate them with the severity of choroidal inflammation. The inflammatory response in the choroid varied from a focal non-granulomatous to a diffuse non-necrotizing granulomatous process. The choriocapillaris was focally involved rather frequently (in 40% of the cases). This was associated with severe inflammation. Chorioretinal adhesions were noted in 7% of the cases. Retinal detachment was observed in 50% of the cases, and this was associated with severe uveal inflammation. Fifty percent of the cases showed retinal perivasculitis and 18% a mild inflammatory infiltrate of the retina. Involvement of the meninges (a finding present in 22% of the cases) and severe inflammation in the scleral canals were both related to the severity of choroidal inflammation. Lens-induced endophthalmitis was observed in 14 cases and was not associated with the severity of the choroidal inflammation. Our observations indicate that the changes interpreted as atypical in SO are usually associated with severe choroidal inflammation, suggesting that these features may be the response to high doses of the antigenic agent. The classical histopathologic description of SO may represent only one manifestation of the pathologic response of this disease.


autoimmunity lens-induced uveitis histopathology sympathetic ophthalmia uveitis 


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  1. 1.
    Blodi, F.C. Sympathetic Uveitis, in Freeman, H. (ed): Ocular Trauma. Appleton-Century-Crofts, New York, pp 417–427 (1979).Google Scholar
  2. 2.
    Easom, H.A. & L.E. Zimmerman. Sympathetic Ophthalmia and bilateral phacoanaphylaxis. A clinicopathologic correlation of the sympathogenic and sympathizing eyes. Arch. Ophthalmol. 72: 9–75 (1964).Google Scholar
  3. 3.
    Faure, J.P. Autoimmunity and the Retina in Current Topics in Eye. Research 2: 215–302 (1980).Google Scholar
  4. 4.
    Fuchs, E. Über sympathisierende Entzündung (Nebst Bemerkungen seröse traumatische Iritis) Arch. F. Ophthalmol. 61: 365–458 (1905).Google Scholar
  5. 5.
    Hogan, M.J. & L.E. Zimmerman. Ophthalmic Pathology. W.B. Saunders Co., Philadelphia, pp 376–382 (1962).Google Scholar
  6. 6.
    Hogan, M.J., J.A. Alvarado & J.E. Weddell. Histology of the Human Eye. W.B. Saunders Co., Philadelphia, p. 344 (1971).Google Scholar
  7. 7.
    Levis, M.L., J.D.M. Gass & W.H. Spencer. Sympathetic uveitis after trauma and vitrectomy. Arch. Ophthlamol. 96: 263–267 (1978).Google Scholar
  8. 8.
    Lubin, J.R., D.M. Albert & M. Weinstein. Sixty-five years of sympathetic ophthalmia. A clinicopathologic review of 105 cases (1913–1978). Ophthalmology 87: 109–121 (1980).Google Scholar
  9. 9.
    Makley, T.A. & A. Azar. Sympathetic Ophthalmia. A longterm follow-up. Arch. Ophthalmol. 96: 257–262 (1978).Google Scholar
  10. 10.
    Marak, G.E. Recent Advances in sympathetic ophthalmia. Surv. Ophthalmol. 24: 141–156 (1979).Google Scholar
  11. 11.
    Marak, G.E., R.L. Font & L.E. Zimmerman. Histopathologic variations related to race in sympathetic ophthalmia. Am. J. Ophthalmol. 78: 935–938 (1974).Google Scholar
  12. 12.
    Marak, G.E., H. Shichi, N.A. Rao & W.B. Wacker. Pattern of experimental allergic uveitis induced by rhodopsin and retinal rod outer segments. Ophthalmic Res. 12: 165–176 (1980).Google Scholar
  13. 13.
    Marak, G.E., W.B. Wacker, N.A. Rao, R. Jack & P.A. Ward. Effects of complement depletion on experimental allergic uveitis. Ophthalmic Res. 11: 97–707 (1979).Google Scholar
  14. 14.
    Rao, N.A., W.B. Wacker & G.E. Marak. Experimental allergic uveitis. Clinicopathologic features associated with varying doses of S antigen. Arch. Ophthalmol. 97: 1954–1958 (1979).Google Scholar
  15. 15.
    Wacker, W.B., N.A. Rao & G.E. Marak. Experimental allergic uveitis in rabbits. Effect of antigen source and dose. Ophthalmic Res. (in press).Google Scholar
  16. 16.
    Waksman, B.H. A comparative histopathologic study of delayed hypersensitivity reaction, in Ciba Symposium on Cellular Aspects of Immunity. Churchill, London, pp 280–292, (1960).Google Scholar

Copyright information

© Dr W. Junk Publishers 1981

Authors and Affiliations

  • Juan O. Croxatto
    • 2
  • Narsing A. Rao
    • 1
  • Ian W. McLean
    • 2
  • George E. Marak
    • 1
  1. 1.Georgetown University Medical CenterWashington, DCUSA
  2. 2.Registry of Ophthalmic Pathology Armed Forces Institute of PathologyWashington, DCUSA

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