Vidal-Villegas Beatriz, Arcos-Villegas Gabriel, Fernández-Vigo José Ignacio, Díaz-Valle David
Ophthalmology Service, Hospital Clínico San Carlos, and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (Idissc), Madrid, Spain.
Red Temática de Investigación Cooperativa Oftared, Instituto de Salud Carlos III, Madrid, Spain.
Ocul Immunol Inflamm. 2022 Jan 2;30(1):16-20. doi: 10.1080/09273948.2020.1787464. Epub 2020 Jul 23.
The most distinctive patterns of posterior pole affectation in syphilitic patients are acute posterior placoid chorioretinitis (ASPPC), pseudoretinitis pigmentosa and panuveitis with white focal preretinal opacities. However, outer retinitis is not a common presenting feature in this disease.
Thus, we report an atypical case of syphilitic outer retinitis (SOR) and severe retinal phlebitis as presenting manifestations in a patient with HIV and syphilis coinfection. We consider that this patient had mixed characteristics of SOR and ASPPC with features of acute zonal occult outer retinopathy (AZOOR) spectrum, which has only rarely been published in recent years.
Prompt and appropriate antibiotic treatment permitted total restoration of the external retinal layers, resolution of retinal vasculitis and recuperation of visual acuity. Since SOR is treatable in contrast to AZOOR, ophthalmologists should be aware that SOR needs to be ruled out when making a diagnosis of AZOOR.
梅毒患者后极部受累最具特征性的表现是急性后极部扁平状脉络膜视网膜病变（ASPPC）、色素性视网膜炎样病变以及伴有白色局限性视网膜前混浊的全葡萄膜炎。然而，外层视网膜病变并非该病常见的临床表现。
因此，我们报告了1例HIV与梅毒合并感染患者，以梅毒外层视网膜病变（SOR）和严重视网膜静脉炎为首发表现的非典型病例。我们认为该患者具有SOR和ASPPC的混合特征，并伴有急性区域性隐匿性外层视网膜病变（AZOOR）谱系特征，近年来仅有极少相关报道。
及时且恰当的抗生素治疗使视网膜外层完全恢复，视网膜血管炎消退，视力恢复。由于与AZOOR不同，SOR是可治疗的，眼科医生应意识到在诊断AZOOR时需要排除SOR。
