Abstract

P 241

Sympathetic ophthalmia after endoresection of choroidal melanoma

Hartmann K., Strauss R. W., Schaller U., Kampik A., Thurau S.
Department of Ophthalmology, Ludwig-Maximilians-University, Munich

Objective: Sympathetic ophthalmia is a rare granulomatous form of uveitis usually seen after perforating injuries and intraocular surgery.
Methods: In the right eye of a 22-year-old woman funduscopy and echography showed an amelanotic subretinal tumour in the anterior part of the fundus with exudative retinal detachment and infiltration of the ciliary body.
Results: After pre-operative single fraction radiotherapy of the Gamma Knife, pars-plana-vitrectomy with endoresection of the tumour and silicone oil filling was performed. An applicator with Ruthenium106 was put on the eye for 3 more days. Several surgeries followed because of complications such as cataract, secondary glaucoma and total retinal detachment. 6 months after radiotherapy of the tumour, the contralateral eye showed an inflammation and sympathetic opthalmia was suspected. 4 weeks later the right eye was enucleated. The result of the histological analysis was a diffuse, non-granulomatous inflammatory infiltrate in the radiation zone and in the choroidea.
Conclusions: Sympathetic ophthalmia after endoresection of choroidal melanoma can be considered an isolated case. Nevertheless, patients with choroidal melanoma that undergo eye sparing surgery, must be informed about these complications. Potentially metastasing tumor is contraindicant to immunosuppressive therapy and would therefore be a challange to the actual therapy.

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