Yang Bo, Xiao Jun, Li XiaoMing, Luo Lifu, Tong Bainan, Su Guanfang
Department of of Ophthalmology, The Second Hospital of Jilin University Nanguan District, Ziqiang Street No. 218, Changchun City 130041, China.
Jilin Province People's Hospital 132000, China.
Int J Clin Exp Med. 2015 Mar 15;8(3):4647-55. eCollection 2015.
Syphilitic chorioretinitis can produce severe vision loss. However, the clinical manifestations of syphilitic chorioretinitis are still unclear, particularly during different stages. Herein, we will present our diagnostic technique for syphilitic chorioretinitis.
This retrospective study recruited 109 cases; we performed a clinical evaluation including case history, serology analysis, fundus photography, fluorescein fundus angiography with or without indocyanine green angiography, auto-fluorescence, and optical coherence tomography.
109 were diagnosed with acute syphilitic posterior placoid chorioretinitis by fundus photograph that revealed filthy, yellowish-white lesions. For autofluorescence, during early-stage syphilitic chorioretinitis, hyperfluorescence could be observed. During the convalescence stage, the fluorescence became hypofluorescence or disappeared. Fluorescein fundus angiography indicated early-stage transmitted fluorescence or hypofluorescence. During the venous stage, the lesion area had fluorescent leakage, mostly accompanied by retinal vasculitis. During the late stage, speckle staining was observed with optic disc fluorescence. Hypofluorescence or undistinguishable fluorescence was seen at an early stage with indocyanine green angiography. At an advanced stage, the lesion had obvious hypofluorescence. Optical coherence tomography indicated various inner segment/outer segment damage, accompanied by retinal pigment epithelium impairment. The inner segment/outer segment alteration could be lessened with treatment.
The clinical manifestations of syphilitic chorioretinitis include impaired vision, shadow blocking, or photopsia of one or both eyes. Fundus photography, fluorescein fundus angiography with or without indocyanine green angiography, autofluorescence, and optical coherence tomography could be useful accessory examinations. Autofluorescence and optical coherence tomography could be the main examinations for monitoring disease progression.
梅毒性脉络膜视网膜炎可导致严重视力丧失。然而，梅毒性脉络膜视网膜炎的临床表现仍不明确，尤其是在不同阶段。在此，我们将介绍我们诊断梅毒性脉络膜视网膜炎的技术。
这项回顾性研究纳入了109例患者；我们进行了临床评估，包括病史、血清学分析、眼底照相、荧光素眼底血管造影（有无吲哚菁绿血管造影）、自发荧光和光学相干断层扫描。
109例经眼底照相诊断为急性梅毒性后极部扁平状脉络膜视网膜炎，显示有污秽的黄白色病变。对于自发荧光，在梅毒性脉络膜视网膜炎早期，可观察到高荧光。在恢复期，荧光变为低荧光或消失。荧光素眼底血管造影显示早期透见荧光或低荧光。在静脉期，病变区域有荧光渗漏，大多伴有视网膜血管炎。在晚期，视盘荧光可见斑点状染色。吲哚菁绿血管造影在早期可见低荧光或无法分辨的荧光。在晚期，病变有明显的低荧光。光学相干断层扫描显示不同程度的内节/外节损害，伴有视网膜色素上皮损伤。内节/外节改变经治疗后可减轻。
梅毒性脉络膜视网膜炎的临床表现包括单眼或双眼视力受损、视物遮挡或闪光感。眼底照相、荧光素眼底血管造影（有无吲哚菁绿血管造影）、自发荧光和光学相干断层扫描可为有用的辅助检查。自发荧光和光学相干断层扫描可为监测疾病进展的主要检查。
