Department of Ophthalmology, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China.
Department of Infectious Diseases, Beijing YouAn Hospital, Capital Medical University, Beijing, 100069, China.
Adv Ther. 2021 Jun;38(6):3362-3372. doi: 10.1007/s12325-021-01755-1. Epub 2021 May 21.
The present study aimed to analyze the clinical features of ocular pathology in patients with acquired immunodeficiency syndrome (AIDS) combined with syphilis.
A total of 129 patients with AIDS and syphilis who first visited the Department of Ophthalmology in Beijing YouAn Hospital between 2012 and 2019 were included in the study. All patients underwent ophthalmologic examinations, such as best-corrected visual acuity (BCVA), slit lamp, intraocular pressure, dilated fundus examination, and color fundus photography as well as systemic examinations related to AIDS and syphilis. The patients were divided into four groups according to fundus disease: a normal fundi group, an HIV-related microvascular retinopathy (MVR) group, a cytomegalovirus retinitis (CMVR) group, and a syphilis-related retinopathy group.
The incidence of fundus disease was 70.7%. There were 36 patients with normal fundi (29.3%), 40 with HIV-related MVR (31.0%), 25 with CMVR (19.4%) (including 11 cases of CMVR with syphilis-related retinopathy), 26 (20.2%) with syphilis-related retinopathy, 1 (0.78%) case with acute retinal necrosis, and 1 (0.78%) case with PORN. The median blood CD4 + T-cell count in the syphilis-associated retinopathy group was 357.5 cells/μl, which was significantly higher than in the other groups; this difference was statistically significant. In the CMVR group, 11 cases with concomitant syphilis-associated retinopathy had lower BCVA and 10 (90.9%) had active inflammatory manifestations in the anterior segment.
The incidence of ocular pathology was high in patients co-infected with AIDS and syphilis, which might manifest in a variety of ocular manifestations; some patients may also have multiple ocular changes, which should be given great clinical attention.
本研究旨在分析获得性免疫缺陷综合征（AIDS）合并梅毒患者的眼部病理学临床特征。
回顾性分析 2012 年至 2019 年间首次在北京佑安医院眼科就诊的 129 例 AIDS 合并梅毒患者的临床资料。所有患者均行眼科检查，包括最佳矫正视力（BCVA）、裂隙灯、眼压、眼底散瞳检查、眼底彩色照相及 AIDS 和梅毒相关的全身检查。根据眼底病变将患者分为四组：眼底正常组、HIV 相关的微血管性视网膜病变（MVR）组、巨细胞病毒视网膜炎（CMVR）组和梅毒相关的视网膜病变组。
眼底病变发生率为 70.7%。眼底正常 36 例（29.3%），HIV 相关 MVR 40 例（31.0%），CMVR 25 例（19.4%）（其中 11 例 CMVR 合并梅毒相关视网膜病变），梅毒相关视网膜病变 26 例（20.2%），急性视网膜坏死 1 例（0.78%），POCN 1 例（0.78%）。梅毒相关视网膜病变组的血 CD4+T 细胞中位数为 357.5 个/μl，明显高于其他组，差异有统计学意义。CMVR 组 11 例合并梅毒相关视网膜病变的患者视力 BCVA 较低，10 例（90.9%）眼前节有活动性炎症表现。
AIDS 合并梅毒患者眼部病理学发生率高，可表现为多种眼部表现，部分患者可能存在多种眼部改变，应引起临床高度重视。
