Atypical Sympathetic Ophthalmia Presenting with Ocular Pain Associated with Posterior Scleral Involvement.

PURPOSE: To describe an atypical case of sympathetic ophthalmia. Design: Case report. RESULTS: A 37 -year-old female presented a 3-day long acute left retroocular pain and photophobia, 1 month after having undergone evisceration of the fellow eye. Upon exploration, the patient presented conjunctival injection, macular retinal folds with peripapillary subretinal fluid, and hypocyanescent choroidal spots on indocyanine green angiography. A sympathetic ophthalmia with a reactive posterior scleritis involvement was diagnosed. The patient underwent treatment with prednisone, mycophenolate, and cyclosporine with slowly tapering, presenting a total recovery over the years. CONCLUSION: Sympathetic ophthalmia may present itself atypically as ocular pain with little vision loss secondarily to a mild panuveitis with reactive scleral involvement.

Possible Intraluminal Obstruction of the XEN45 Gel Stent Observed With Anterior Segment Optical Coherence Tomography.

PURPOSE: We herein describe possible intraluminal obstruction because of a hyperreflective material found in anterior segment optical coherence tomography (AS-OCT) in 16 of 46 cases with XEN45 gel stent. MATERIALS AND METHODS: This is a retrospective case series of 46 eyes of 39 patients with noncomplicated XEN45 gel stent surgery, analyzed with AS-OCT and slit-lamp photography after at least 6 postoperative months. RESULTS: Possible luminal obstruction in the subconjunctival segment of the implant was observed in 16 eyes of 15 patients, characterized by hyperreflective material on AS-OCT, which was not visible in slit-lamp photography. This was found in 15 eyes following combined procedures and in 1 eye following XEN45 alone. None showed signs of filtering bleb on AS-OCT or slit-lamp photography. In 1 case, the discontinuity between the hyperreflective material and subconjunctival opening of the implant tube was evidenced, and in another case, a focal deposit in the intracameral end of the implant was seen. CONCLUSIONS: We have successfully described the lumen implant deposit of material as a possible cause of late failure of the implant. AS-OCT allows the identification of such cases and may be useful to plan further postoperative interventions for better patient outcomes.