Yokoi Masahiko, Kase Manabu
Department of Ophthalmology, Teine Keijin-kai Hospital, Sapporo, Japan.
Jpn J Ophthalmol. 2004 Jan-Feb;48(1):65-7. doi: 10.1007/s10384-003-0011-5.
Retinal vasculitis is one of the manifestations of ocular syphilis.
A 29-year-old man was referred to our hospital with the complaint of sudden visual loss in the left eye lasting more than three weeks.
Ophthalmoscopic examination showed retinal hemorrhages, edema, and sheathing of large retinal arteries and veins. Fluorescein angiography revealed extensive occlusion of the affected retinal arteries, veins, and capillaries. Little evidence of uveitis or vitritis was observed. The fluorescent treponemal antibody-absorption test was positive, and the Treponema pallidum hemagglutination titer was 1:10,240. The treatment with penicillin was effective, leading to resolution of the retinal hemorrhages and edema, although occlusion of the retinal vessels persisted.
Vascular occlusion occurred simultaneously in large retinal arteries, arterioles, and capillaries as well as in segments of retinal veins, resulting in irreversible changes in the vascular walls.
视网膜血管炎是眼部梅毒的表现之一。
一名29岁男性因左眼突发视力丧失持续超过三周而被转诊至我院。
眼底镜检查显示视网膜出血、水肿，以及视网膜大动静脉鞘膜形成。荧光素血管造影显示受累视网膜动脉、静脉和毛细血管广泛闭塞。未观察到葡萄膜炎或玻璃体炎的明显证据。荧光密螺旋体抗体吸收试验呈阳性，梅毒螺旋体血凝试验滴度为1:10240。青霉素治疗有效，视网膜出血和水肿消退，尽管视网膜血管闭塞持续存在。
视网膜大动脉、小动脉和毛细血管以及视网膜静脉节段同时发生血管闭塞，导致血管壁出现不可逆变化。
