Sympathetic Ophthalmia: latest immunomodulatory approaches and clinical outcomes
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Purpose
Recent studies regarding SO showed a better disease control with systemic steroids and immunomodulatory treatment (IMT) although most patients in these studies were treated with ciclosporin, which is notoriously avoided nowadays due to its nephrotoxicity, and no patient was treated with Tocilizumab.
We aimed to describe the clinical outcomes of modern IMT in SO, in the setting of a tertiary Ophthalmology center in France.
Methods
Retrospective observational single-center study: all patients with suspected SO seen between January 2008 and November 2024 within the Ophthalmology department in Pitié-Salpêtrière Hospital, with a follow-up over 10 months were screened.
Results
We identified 19 patients with suspected SO. Among these patients, 2 had uveitis before trauma, 1 had missing files, 1 had a differential diagnosis of posterior uveitis.15 patients with confirmed SO were included.
Mean follow-up was 11.8±3.9 [350-10220] years. Sex ratio was 1:1.66 with 60% male patients. SO occured within a mean 5.19±3.9 [0.16-29] years (median : 2.13 years). Trauma and multiple intraocular surgeries in the fellow eye were present in all patients.
Interferon-α-2a (IFN-α-2a) and Tocilizumab both showed the best results in disease control, with more durable inflammation control and tolerance profile. Intravitreal anti-VEGF injections were added in case of associated choroidal neovascularization.
Conclusion
Management of SO has significantly evolved over the past decades, with new immunomodulatory or immunosuppressive approaches providing an improved tolerance profile and better clinical outcomes. IFN-α-2a and Tocilizumab appeared as the most efficient IMT to achieve inflammation control.
Conflict of interest
No
1
Last name
KITIC
Initials of first name(s)
N
Department
Pitié-Salpêtrière Hospital, Ophthalmology department
City
Paris
Country
France
2
Last name
TOUTEE
Initials of first name(s)
A
Department
Pitié-Salpêtrière Hospital, Ophthalmology department
City
Paris
Country
France
3
Last name
AUGER
Initials of first name(s)
A
Department
Pitié-Salpêtrière Hospital, Ophthalmology department
City
Paris
Country
France
4
Last name
FARDEAU
Initials of first name(s)
C
Department
Pitié-Salpêtrière Hospital, Ophthalmology department
City
Paris
Country
France
5
Last name
KITIC
Initials of first name(s)
A
Department
Tenon Hospital, Plastic Surgery department
City
Paris
Country
France
6
Last name
GHEMBAZA
Initials of first name(s)
A
Department
Pitié-Salpêtrière Hospital, Internal Medicine department
City
Paris
Country
France
7
Last name
HIE
Initials of first name(s)
M
Department
Pitié-Salpêtrière Hospital, Internal Medicine department
City
Paris
Country
France
8
Last name
SAADOUN
Initials of first name(s)
D
Department
Pitié-Salpêtrière Hospital, Internal Medicine department
City
Paris
Country
France
9
Last name
BODAGHI
Initials of first name(s)
B
Department
Pitié-Salpêtrière Hospital, Ophthalmology department
City
Paris
Country
France
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