Wickremasinghe Sanjeewa, Ling Cecilia, Stawell Richard, Yeoh Jonathan, Hall Anthony, Zamir Ehud
The Ocular Immunology Clinic, The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Ophthalmology. 2009 Jun;116(6):1195-200. doi: 10.1016/j.ophtha.2008.12.055. Epub 2009 Apr 19.
To describe the features of an unusual syphilitic uveitis syndrome in a cluster of homosexual patients.
Retrospective case series.
Five consecutive patients diagnosed with syphilitic retinitis in our Melbourne uveitis clinic over a period of 8 months.
The case notes of patients diagnosed with syphilitic retinitis were reviewed and the clinical features are presented and discussed.
Description of retinal findings and documentation of any associated sequelae.
All patients were homosexual men. Two were human immunodeficiency virus positive. None of the patients had been previously diagnosed with syphilis, although 3 presented with systemic symptoms and signs of secondary syphilis. All patients had marked anterior uveitis and vitritis. All patients had acute retinal arteriolitis and inner retinitis, with distinctive, inner retinal and preretinal white dots. These retinal findings were remarkably similar in all patients, and resolved with little or no sequelae after standard systemic treatment for syphilis, combined with oral prednisolone.
Syphilitic retinitis may be an increasingly common clinical problem, reflecting the growing incidence of syphilis among homosexual men in Australia. Our patients showed stereotypical ocular and systemic features, which are useful in differentiating this condition clinically from other types of acute posterior uveitis, such as necrotizing viral retinitis.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
描述一组同性恋患者中一种不寻常的梅毒性葡萄膜炎综合征的特征。
回顾性病例系列。
在8个月期间，墨尔本葡萄膜炎诊所连续5例被诊断为梅毒性视网膜炎的患者。
回顾诊断为梅毒性视网膜炎患者的病历，并呈现和讨论临床特征。
描述视网膜病变并记录任何相关后遗症。
所有患者均为男同性恋者。2例为人类免疫缺陷病毒阳性。尽管3例患者出现二期梅毒的全身症状和体征，但之前均未被诊断为梅毒。所有患者均有明显的前葡萄膜炎和玻璃体炎。所有患者均有急性视网膜小动脉炎和视网膜内层炎，伴有独特的视网膜内层和视网膜前白色斑点。所有患者的这些视网膜病变非常相似，在梅毒标准全身治疗联合口服泼尼松龙后，病变几乎完全消退，很少或没有后遗症。
梅毒性视网膜炎可能是一个日益常见的临床问题，反映了澳大利亚男同性恋者中梅毒发病率的上升。我们的患者表现出典型的眼部和全身特征，这有助于在临床上将这种疾病与其他类型的急性后葡萄膜炎，如坏死性病毒性视网膜炎区分开来。
在参考文献之后可能会发现专有或商业披露。
