Forouzan Parsha, Fell David, Jones Freddie R
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Ocul Immunol Inflamm. 2023 Apr;31(3):649-652. doi: 10.1080/09273948.2022.2042321. Epub 2022 Feb 28.
The case draws attention to syphilis as a cause of chronic postoperative uveitis following cataract surgery and is the first to document transient worsening of ocular inflammation without systemic symptoms after initiation of treatment, suggesting a localized Jarisch-Herxheimer-like reaction.
Case report.
The average thickness of the retinal nerve fiber layer was used as an objective measure of intraocular inflammation. The patient's nerve edema worsened during a standard neurosyphilis treatment course and returned to normal several weeks after completion of therapy.
Syphilis serologic testing should be strongly considered in the work-up for chronic postoperative uveitis. A localized ocular Jarisch-Herxheimer-like reaction may occur and should not detract from completion of neurosyphilis treatment.
该病例引起了人们对梅毒作为白内障手术后慢性葡萄膜炎病因的关注，并且是首个记录在治疗开始后眼部炎症短暂恶化但无全身症状的病例，提示存在局部类赫氏反应。
病例报告。
视网膜神经纤维层的平均厚度被用作眼内炎症的客观测量指标。在标准的神经梅毒治疗过程中，患者的神经水肿加重，治疗完成几周后恢复正常。
在慢性术后葡萄膜炎的检查中应强烈考虑梅毒血清学检测。可能会发生局部眼部类赫氏反应，且不应妨碍神经梅毒治疗的完成。
