Nurfahzura Mohd-Jamil, Hanizasurana Hashim, Zunaina Embong, Adil Hussein
Department of Ophthalmology, Hospital Selayang, Lebuhraya Selayang-Kepong, Selangor, Malaysia ; Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia ; Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, Kelantan, Malaysia.
Clin Ophthalmol. 2013;7:1651-4. doi: 10.2147/OPTH.S46876. Epub 2013 Aug 20.
We report successful treatment of syphilitic uveitis in a case series of three Human immunodeficiency virus (HIV)-positive patients at Malaysia's Selayang Hospital eye clinic. All three patients with syphilitic uveitis were male, aged from 23 to 35 years old, with a history of high-risk behaviors. Of the patients, two presented with blurring of vision and only one patient presented with floaters in the affected eye. Ocular examination revealed intermediate uveitis (case 1 and case 3) and panuveitis (case 2). Each patient showed a high Venereal Disease Research Laboratory (VDRL) titer at presentation and they were also newly diagnosed as HIV positive with variable CD4 counts. All three patients responded well to a neurosyphilis regimen of intravenous penicillin G. At 3 months posttreatment, there was reduction in VDRL titer with improvement of vision in the affected eye. Diagnosis of syphilis needs to be ruled out in all cases of uveitis. All syphilitic uveitis cases should have HIV screening and vice versa, as syphilis is one of the most common infectious diseases associated with HIV-positive patients. Early detection and treatment are important for a good visual outcome.
我们报告了马来西亚士拉央医院眼科门诊对3例人类免疫缺陷病毒（HIV）阳性患者的梅毒性葡萄膜炎进行成功治疗的病例系列。所有3例梅毒性葡萄膜炎患者均为男性，年龄在23至35岁之间，有高危行为史。其中，2例患者出现视力模糊，仅1例患者患眼有飞蚊症。眼科检查发现中度葡萄膜炎（病例1和病例3）和全葡萄膜炎（病例2）。每位患者就诊时梅毒血清学试验（VDRL）滴度均很高，且均为新诊断出的HIV阳性，CD4细胞计数各不相同。所有3例患者对静脉注射青霉素G的神经梅毒治疗方案反应良好。治疗3个月后，VDRL滴度降低，患眼视力改善。所有葡萄膜炎病例均需排除梅毒诊断。所有梅毒性葡萄膜炎病例均应进行HIV筛查，反之亦然，因为梅毒是与HIV阳性患者相关的最常见传染病之一。早期发现和治疗对于良好的视力预后很重要。
