A work accident leaves a woman blind in one eye. As she copes with the loss, within months the vision in the other, previously uninjured eye begins to blur, and the eye becomes red and inflamed.
The rare eye condition, known as sympathetic ophthalmia, occurs when vision is lost in one eye through injury or multiple surgeries, and the body's overactive immune system attacks the remaining healthy eye. Left untreated, a person can become completely blind.
However, University of Iowa ophthalmologists and colleagues have tested and are now using a surgical implant called Retisert to prevent complete vision loss and eliminate dependence on systemic, or whole-body, immunosuppression. Before use of the surgical technique, doctors had to "shut down" a person's entire immune system to stop the attack on the remaining good eye.
"Until recently, the primary treatment option for sympathetic ophthalmia was non-surgical and involved high doses of oral steroids followed by oral immunosuppressive medication to preserve vision in a patient's remaining eye," said Vinit Mahajan, M.D., Ph.D., assistant professor of ophthalmology and visual sciences at the University of Iowa Carver College of Medicine and a retinal surgeon with University of Iowa Hospitals and Clinics.
"But this treatment, similar to organ transplantation cases, subjects patients to life-long use of immunosuppressive drugs that have serious side effects such as osteoporosis, weight gain, potentially life-threatening infection and liver or kidney damage," he added.
The new Retisert treatment involves the surgical implantation into the endangered eye of a small plastic tab that contains a slow-release steroid called fluocinoloe acetonide. The insert provides immunosuppression only to the endangered eye, not other body parts. It lasts for about two-and-a-half years and then can be replaced.
Along with University of Iowa retinal surgeons James Folk, M.D., pro
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University of Iowa