Relationship between sympathetic ophthalmia, phacoanaphylatic endophthalmitis, and Vogt-Koyanagi-Harada disease. 1988

C C Chan
Laboratory of Immunology, National Eye Institute, Bethesda, MD 20892.

The more than coincidental occurrence of phacoanaphylatic endophthalmitis (PE) in sympathetic ophthalmia, and the similarity of the dissimilarity between Vogt-Koyanagi-Harada (VKH) disease and sympathetic ophthalmia have been well described both clinically and histopathologically. The etiology and pathogenesis of these three diseases are still not fully understood. Identifying and distinctive characteristics among them include the history of ocular trauma in sympathetic ophthalmia, rupture of the lens capsule in phacoanaphylatic endophthalmitis, and involvement of the skin, ear, and central nervous system in VKH disease. A T-cell-mediated immune reaction to ocular antigens seems to play a major role in sympathetic ophthalmia and VKH disease. A B-cell-related Arthus reaction to lens antigen seems to be the principle mechanism of PE. Thus, these three diseases may represent a spectrum of uveitis. At one end is the delayed-type hypersensitivity disease of sympathetic ophthalmia, whereas at the opposite end is the immune complex disease of PE, with VKH disease in the middle of this uveitic spectrum.

UI MeSH Term Description Entries
D007908 Lens, Crystalline A transparent, biconvex structure of the EYE, enclosed in a capsule and situated behind the IRIS and in front of the vitreous humor (VITREOUS BODY). It is slightly overlapped at its margin by the ciliary processes. Adaptation by the CILIARY BODY is crucial for OCULAR ACCOMMODATION. Eye Lens,Lens, Eye,Crystalline Lens
D009877 Endophthalmitis Suppurative inflammation of the tissues of the internal structures of the eye frequently associated with an infection. Ophthalmia,Infectious Endophthalmitis,Endophthalmitides,Endophthalmitides, Infectious,Endophthalmitis, Infectious,Infectious Endophthalmitides,Ophthalmias
D005123 Eye The organ of sight constituting a pair of globular organs made up of a three-layered roughly spherical structure specialized for receiving and responding to light. Eyes
D005131 Eye Injuries Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries. Injuries, Eye,Eye Injury,Injury, Eye
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000305 Adrenal Cortex Hormones HORMONES produced by the ADRENAL CORTEX, including both steroid and peptide hormones. The major hormones produced are HYDROCORTISONE and ALDOSTERONE. Adrenal Cortex Hormone,Corticoid,Corticoids,Corticosteroid,Corticosteroids,Cortex Hormone, Adrenal,Hormone, Adrenal Cortex,Hormones, Adrenal Cortex
D001323 Autoantibodies Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them. Autoantibody
D012422 Rupture, Spontaneous Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force. Ruptures, Spontaneous,Spontaneous Rupture,Spontaneous Ruptures
D014605 Uveitis Inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (sclera and cornea, and the retina). (Dorland, 27th ed) Uveitides
D014607 Uveomeningoencephalitic Syndrome A syndrome characterized by bilateral granulomatous UVEITIS with IRITIS and secondary GLAUCOMA, premature ALOPECIA, symmetrical VITILIGO, poliosis circumscripta (a strand of depigmented hair), HEARING DISORDERS, and meningeal signs (neck stiffness and headache). Examination of the cerebrospinal fluid reveals a pattern consistent with MENINGITIS, ASEPTIC. (Adams et al., Principles of Neurology, 6th ed, p748; Surv Ophthalmol 1995 Jan;39(4):265-292) Uveomeningoencephalitis,Vogt-Koyanagi-Harada Syndrome,Syndrome, VKH (Vogt Koyanagi Harada),Syndrome, Vogt Koyanagi Harada,VKH (Vogt Koyanagi Harada) Syndrome,VKH Syndrome,Vogt-Koyanagi-Harada Disease,Disease, Vogt-Koyanagi-Harada,Syndrome, Uveomeningoencephalitic,Syndrome, VKH,Syndrome, Vogt-Koyanagi-Harada,Uveomeningoencephalitides,VKH Syndrome (Vogt Koyanagi Harada),Vogt Koyanagi Harada Disease,Vogt Koyanagi Harada Syndrome

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