Choroidal Neovascularization in Sympathetic Ophthalmia

A 49-year-old man presented after a ruptured globe repair of his left eye status post a bungee cord injury with decreased vision in his right eye six weeks after the trauma occurred. Visual acuities were 20/40 in the right eye and no light perception in the left eye. Intraocular pressures were 27 and 5, respectively. Slit lamp examination of the right eye revealed 1+ conjunctival injection, fine keratic precipitates and 1+ anterior chamber cells. Examination of the left eye revealed a sutured corneal laceration with no view of the iris or lens. Fundus examination and fluorescein angiography of the right eye revealed papillitis, vasculitis and peripheral choroidal lesions consistent with DalenFuchs nodules. He was diagnosed with sympathetic ophthalmia. He underwent enucleation of the left eye and was started on Pred Forte therapy, Prednisone and CellCept. He failed CellCept therapy and eventually was started on Leukeran.