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中国人群梅毒葡萄膜炎的临床表现及治疗结果

Clinical Manifestations and Treatment Outcomes of Syphilitic Uveitis in a Chinese Population.

作者信息

Zhang Rui, Qian Jiang, Guo Jie, Yuan Yifei, Xue Kang, Yue Han, Chen Ling

机构信息

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China; Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China.

Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.

出版信息

J Ophthalmol. 2016;2016:2797028. doi: 10.1155/2016/2797028. Epub 2016 Apr 10.

Abstract

Purpose. To describe the clinical manifestations and treatment outcomes of syphilitic uveitis in a Chinese population. Methods. This is a retrospective case series of 15 consecutive patients with syphilitic uveitis treated at a uveitis referral center between 2012 and 2015. Results. Fifteen patients were diagnosed with syphilitic uveitis based on positive serological tests. Nine patients were male. Coinfection with human immunodeficiency virus was detected in two patients. Twenty eyes presented with panuveitis and all patients had posterior involvement. The most frequent manifestations were retinal vasculitis and papillitis, while syphilitic posterior placoid chorioretinitis was only found in three eyes. All patients received systemic penicillin therapy according to CDC guidelines. Nine patients were misdiagnosed before presenting to our center and the delay in treatment with penicillin was associated with poor final visual outcomes (P < 0.05). Conclusions. In our series, both male and female were almost equally affected and coinfection of syphilis with human immunodeficiency virus was uncommon. All patients in this study had posterior involvement and the most common manifestations were retinal vasculitis and papillitis. Syphilis should be considered as an important differential diagnosis especially for posterior uveitis and panuveitis. Early diagnosis and appropriate treatment are important for visual prognosis.

摘要

目的。描述中国人群中梅毒性葡萄膜炎的临床表现及治疗结果。方法。这是一项回顾性病例系列研究,纳入了2012年至2015年间在一家葡萄膜炎转诊中心接受治疗的15例连续性梅毒性葡萄膜炎患者。结果。15例患者根据血清学检查阳性确诊为梅毒性葡萄膜炎。9例为男性。2例患者检测出合并人类免疫缺陷病毒感染。20只眼表现为全葡萄膜炎,所有患者均有后部受累。最常见的表现为视网膜血管炎和视乳头炎,而梅毒性后极部扁平状脉络膜视网膜病变仅在3只眼中发现。所有患者均根据美国疾病控制与预防中心(CDC)指南接受全身青霉素治疗。9例患者在就诊于我们中心之前被误诊,青霉素治疗延迟与最终视力不佳相关(P < 0.05)。结论。在我们的系列研究中,男性和女性受累情况几乎相同,梅毒合并人类免疫缺陷病毒感染并不常见。本研究中的所有患者均有后部受累,最常见的表现为视网膜血管炎和视乳头炎。梅毒应被视为重要的鉴别诊断,尤其是对于后葡萄膜炎和全葡萄膜炎。早期诊断和恰当治疗对视力预后很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ee/4842054/b66042e84529/JOPH2016-2797028.001.jpg

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