A case of sympathetic ophthalmia secondary to silicone oil granuloma

摘要

BACKGROUND: Sympathetic ophthalmia occurred after removal of silicone oil(SO) from a blind eye with chronic retinal detachment for 20 years. The enucleated eye was examined histopathologically. CASE: A 22-year-old man had been diagnosed with traumatic retinal detachment from blunt trauma to his left eye when he was 3 years old. Pars plana vitrectomy with SO injection was performed at that time, but he lost the sense of light in that eye. Twenty years later, he experienced ocular pain because of absolute glaucoma. Sympathetic ophthalmia has occurred after pars plana vitrectomy with removal of SO and cyclophotocoagulation. The left eye was enucleated and examined histopathologically. RESULT: Histopathological study of the enucleated eye revealed necrosis of the ciliary body due to cyclophotocoagulation. Multiple small round empty spaces which may have been SO droplets were observed in the preretinal membrane, the subretinal space, and the choroidal stroma. In the choroid, diffuse granulomatous inflammation which could be called "silicone oil granuloma" was observed. Calcified drusens were seen at the peripheral fundus. DISCUSSION: An eye containing injected SO for a long period might develop SO granuloma in the choroid and such condition could be the basis for subsequent sympathetic ophthalmia if a second operation with uveal damage was added.