Die sympathische Oph-thalmie im Lichte experimenteller Forschungen
Marchesani, O.
Arch Augenheilk 100/101: 606-679
1929
Accession: 024486701
Stimulated by the observation of a case of sympathetic ophthalmitis from which B. subtilis was isolated, the author instituted a series of experiments on rabbits, attempting to reproduce the lesion. The technique varied in successive series but in no instance was a clear cut case of sympathetic ophthalmitis produced. Following the 3rd injection, there was set up in a number of animals a choroiditis in the 2nd eye. The method in general consisted of injecting cultures of B. subtilis into the lens of the eye at several week intervals, and daily observtion of the eyes. The author concludes that there is no specific etiological agent responsible for all cases of this lesion. A number of agents are reported in the literature as having been successfully used experimentally and various organisms are recovered from human cases. An agent to cause sympathetic ophthalmitis must have a highly specialized affinity for ocular tissues coupled with relative low pathogenicity. These requirements indicate that not only the etiological agent but also the condition of the invaded tissues must play a role. Any of the usual pathogenic organisms may be the inciting agent provided they meet these requirements. However, it must be pointed out that a generalized infection is to be avoided in order to meet the criticism that the involvement of the second eye is not a blood borne metastasis of the organism. This is one of the difficult points in animal experimentation. In human disease a generalized infection arising from the eye is quite rare, whereas experimentally it is frequently seen. Turning from the nature of the incitant to the tissues involved, the principle of all successful experiments seems to be the setting up of an infection which produces an inflammation of some standing. The interpretation of this requirement would probably mean the producing of an allergic condition in the tissues. Analysis of previously successful experiments supports this theory. The sympathetic ophthalmitis can be successfully reproduced in animals by using toxins but the application of this principle to human lesions is at present without experimental support.