The Role of Sex in Uveitis and Ocular Inflammation

Ian Y. L. Yeung, MD; Nicholas A. Popp, BS; Chi-Chao Chan, MD


Int Ophthalmol Clin. 2015;55(3):111-131. 

In This Article

Male Predominant Uveitides Without Systemic Involvement

Sympathetic ophthalmia (SO) is a rare condition that occurs after the uvea of 1 eye is subjected to a penetrating injury (eg, by trauma or surgery). Pathologically, it is similar to VKH, but SO lacks VKH's extraocular manifestations. Injury to the "exciting eye" results in an inflammatory response that develops later (90% of cases are within 1 y) in the uninjured "sympathizing eye."[17] As men are more likely to suffer penetrating ocular trauma due to occupational and lifestyle factors, there seems an increased prevalence in men with 50% to 72.1% of SO patients being male.[17,134,135] In postsurgical cases, there have been no reported sex differences.[17,134] So it classically presents as acute bilateral granulomatous inflammation with mutton-fat keratic precipitates, aqueous cells and flare, iridocyclitis, and posterior synechiae. Posterior segment signs include vitritis, optic disc swelling, and Dalen-Fuchs nodules with choroidal infiltration and thickening.[17,136–139]

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is the only member of the white dot syndromes to be more prevalent in men. Of 405 APMPPE patients, 54% were male.[109] APMPPE presents with bilateral multiple yellow-white placoid lesions at the posterior pole. The lesions fade over 1 to 2 weeks, usually with significant sequelae. Although the etiology is not fully understood, a viral factor is thought to be involved.[109]