To discuss the diagnostic and treatment challenges of sympathetic ophthalmia (SO) in a pregnant patient with proliferative diabetic retinopathy (PDR).
Approach:
Case Presentation: A 27-year-old woman with a history of poorly controlled type 1 diabetes presented with declining vision and was diagnosed with SO following penetrating ocular trauma.
Treatment: The patient received intravenous methylprednisolone and adalimumab as a steroid-sparing agent, leading to improved visual acuity and control of uveitis.
Key Findings:
SO can occur in conjunction with PDR, complicating diagnosis and treatment.
High-dose systemic corticosteroids are the primary treatment for SO, but may exacerbate hyperglycemia in diabetic patients.
Adalimumab is effective in managing SO and can facilitate corticosteroid tapering.
Limitations:
The rarity of SO in conjunction with PDR limits generalizability.
Long-term outcomes and the impact of pregnancy on SO management require further study.
