Reddy S, Cubillan L D P, Hovakimyan A, Cunningham E T
Francis I Proctor Foundation, UCSF, San Francisco, California, USA.
Br J Ophthalmol. 2007 Dec;91(12):1610-2. doi: 10.1136/bjo.2007.123174. Epub 2007 May 23.
To determine the prevalence and clinical characteristics of the inflammatory ocular hypertension syndrome (IOHS) in patients with uveitis and serological evidence of syphilis.
A retrospective, observational case review of 39 consecutive patients with uveitis and serological evidence of syphilis was carried out between January 1977 and December 2001. Other causes of uveitis were excluded. The prevalence and clinical characteristics of IOHS among patients with uveitis and serological evidence of syphilis were documented. IOHS was defined as an increase in intraocular pressure (IOP) of more than 21 mm Hg that began at the onset of acute, recurrent, or chronic anterior chamber inflammation and reversed promptly with appropriate anti-inflammatory or antimicrobial treatment.
Of the 39 patients with uveitis and serological evidence of syphilis, eight eyes from seven patients (18%) presented with IOHS, a significantly higher prevalence than in the uveitis population at large (2.3%; p<0.001). Best-corrected visual acuity varied from 20/20 to 20/200, with a median of 20/40, and three of the eight eyes (37.5%) had granulomatous features, including large keratic precipitates and, in two eyes, Koeppe nodules. Intraocular pressure varied from 23 to 51 mm Hg, with a mean of 36 and a median of 34. One patient had bilateral IOHS.
Syphilitic uveitis should be included in the differential diagnosis of IOHS along with more commonly recognised causes.
确定葡萄膜炎合并梅毒血清学证据患者中炎症性高眼压综合征（IOHS）的患病率及临床特征。
对1977年1月至2001年12月期间连续收治的39例葡萄膜炎合并梅毒血清学证据的患者进行回顾性观察病例分析。排除葡萄膜炎的其他病因。记录葡萄膜炎合并梅毒血清学证据患者中IOHS的患病率及临床特征。IOHS定义为在急性、复发性或慢性前房炎症发作时眼压（IOP）升高超过21 mmHg，并在适当的抗炎或抗菌治疗后迅速恢复正常。
在39例葡萄膜炎合并梅毒血清学证据的患者中，7例患者的8只眼（18%）出现IOHS，其患病率显著高于总体葡萄膜炎患者（2.3%；p<0.001）。最佳矫正视力从20/20至20/200不等，中位数为20/40，8只眼中有3只眼（37.5%）具有肉芽肿特征，包括大量角膜后沉着物，其中2只眼有科佩结节。眼压从23至51 mmHg不等，平均为36 mmHg，中位数为34 mmHg。1例患者为双侧IOHS。
梅毒相关性葡萄膜炎应与更常见的病因一起纳入IOHS的鉴别诊断。
