MONITORING OF THERAPEUTIC EFFECTS WITH THE LASER FLARE-CELL METER IN SYMPATHETIC OPHTHALMIA

Background The Laser Flare-Cell Meter allows noninvasive quantitative measurement of aqueous flare in human eyes. In this study we analysed changes of aqueous flare in eyes with sympathetic ophthalmia under immunsuppressive treatment. Patients and method Two men (54- and 59-year-old) with sympathetic ophthalmia (histological examination of the enucleated eyes confirmed the clinical diagnosis) were examined regularly with the Laser Flare-Cell Meter (Kowa). According to the flare values the dose of immunsuppressive treatment with cyclosporin A and prednisolone was gradually titrated. Results Under immunsuppressive treatment flare values of patient 1 normalized within 21 months. The dose of immunsuppressive treatment was carefully reduced according to flare values. Patient 2 showed very high flare values before treatment, which decreased to flare values of 20 flare counts/ms within 5 months of treatment with cyclosporin A and prednisolone. Both patients stopped immunsuppressive treatment because of systemic side-effects. Thereafter flare values increased acutely and a recurrence of sympathetic ophthalmia was observed in both patients. Under renewed immunsuppressive treatment aqueous flare values decreased again. Conclusion Measurement of aqueous flare with the LFCM appears to be an effective tool for follow-up examinations, and especially for titrating of immunsuppressive treatment in eyes with manifest sympathetic ophthalmia.