Sympathetic ophthalmia following radiation-induced scleral necrosis in choroidal melanoma

被引:1
作者
Chen, Yen-Cheng [1 ]
Chao, Yu-Jang [2 ,3 ]
Tsai, Chieh-Chih [1 ,2 ]
Chen, Shih-Jen [1 ,2 ]
Hwang, De-Kuang [1 ,2 ]
机构
[1] Taipei Vet Gen Hosp, Dept Ophthalmol, 201,Sect 2,Shipai Rd, Taipei 11217, Taiwan
[2] Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei, Taiwan
[3] Cheng Hsin Gen Hosp, Dept Ophthalmol, Taipei, Taiwan
关键词
Choroidal melanoma; Gamma Knife radiotherapy; orbital; radiation-induced scleral necrosis; sympathetic ophthalmia; tumor; UVEAL MELANOMA; IRRADIATION;
D O I
10.4103/2211-5056.360046
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Sympathetic ophthalmia (SO) is a bilateral granulomatous panuveitis. We report a rare case of SO presenting after scleral necrosis as a late complication of Gamma Knife radiotherapy for choroidal melanoma. A 55-year-old woman presented with primary choroidal melanoma in the right eye and has been treated with Gamma Knife radiotherapy with stable tumor size. Five years after radiotherapy, a pigmented protrusive uveal mass was visibly noted over the superior sclera of the same eye, corresponding to periocular soft tissue enhancement on computed tomography. Biopsies of the pigmented mass showed the absence of malignancy. One month later, acute blurred vision with signs of sympathetic ophthalmia developed in the left eye. The patient received high-dose systemic corticosteroids and immunomodulatory therapy. The intraocular inflammation in the left eye subsided with improving vision, and the uveal mass in the right eye flattened after the anti-inflammatory therapy. Scleral necrosis is a rare complication following radiotherapy for choroidal melanoma and may incite sympathetic ophthalmia, for which prompt and aggressive treatment is important to save vision, especially for the fellow eye.
引用
收藏
页码:548 / 551
页数:4
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