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Master Thesis

Ophtalmie sympathique : suivi au long-cours

Abstract : Objective: to evaluate retrospectively the long-term visual outcome and steroid-sparing related to successive steps of the medico-surgical management of sympathetic ophthalmia (SO). Methods: medical records of patients with SO, followed in a reference center for rare diseases, for at least 3 years, were reviewed for history of ocular trauma or surgery and subsequent development of SO, presenting symptoms, treatments, and visual outcomes. Results: Ten patients fitted the inclusion criteria. The median time of SO occurrence was 1,5 years. At admission, median best-corrected visual acuity (BCVA) was 0,45 LogMAR [0,2;0,65], median steroid dependence daily dose was 40 mg [30;65], and inflammatory macular edema was present in 7/10 eyes. The median time of follow up was 14 years [6,5;25]. At the end of follow-up, there were no significative improvement for the BCVA with a median of 0,4 LogMAR [0,1;0,75] p=0,87. However, the median daily prednisone dose was significantly decreased to 8 mg [3,5;12,5] p<0,01. At six months on prednisone associated to immunosuppressive drugs, inflammation and macular edema control was assessed using antimetabolites in 4/6 treatments, anti TNF-alpha in 0/3 treatments, cyclophosphamide in 0/1 treatment, cyclosporine in 0/1 treatment, interferon-α-2a in 6/6 treatments, polyvalent immunoglobulin in 0/1 treatment, enucleation in 0/3 treatments. Conclusion: Interferon-α-2a and antimetabolites seemed to be useful in case of macular edema and in steroid sparing unlike enucleation which appeared to be pejorative in uveitis course in that small series.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03346753
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Submitted on : Thursday, September 16, 2021 - 3:47:56 PM
Last modification on : Thursday, February 17, 2022 - 5:53:13 PM

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Beverly Casalan. Ophtalmie sympathique : suivi au long-cours. Organes des sens. 2020. ⟨dumas-03346753⟩

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