Sympathetic ophthalmia complicating helium ion irradiation of a choroidal melanoma
P. D. Fries, D. H. Char, J. B. Crawford and W. Waterhouse
Department of Ophthalmology, University of California, San Francisco 94143.
Sympathetic ophthalmia was diagnosed 49 months after helium ion irradiation
of a left choroidal melanoma. The patient maintained good vision until 18
months after therapy, when she developed neovascular glaucoma. This
complication required multiple therapeutic procedures, including topical
anti-inflammatory and antiglaucomatous drops, 360 degrees peripheral
panretinal cryoblation, and a single 180 degrees application of inferior
cyclocryotherapy over a 2 1/2-year period. Four weeks after the
cyclocryotherapy, inflammation was noted in both eyes, and, one month
later, enucleation of the left sympathogenic eye was performed. Serial
histopathologic sections showed a full-thickness, fibrovascular, scleral
scar and tantalum marker ring suture without uveal incarceration.
Penetrating surgical trauma, a uveal melanoma, and multiple nonpenetrating
treatments resulted in the development of sympathetic ophthalmia.
