一组眼梅毒病例系列的临床特征，其中3例在晚期诊断后需要多次玻璃体切除术
Clinical Characteristics of a Case Series of Ocular Syphilis With 3 Cases Requiring Multiple Vitrectomies After Late Diagnosis.
作者信息
Nagarajan Eric, Mundae Rusdeep, Tran Tu M, Mammo Danny A, Murray Jared, Yamanuha Justin, Koozekanani Dara, Montezuma Sandra R
机构信息
Department of Ophthalmology & Visual Neurosciences, University of Minnesota Medical School, Minneapolis, MN, USA.
出版信息
J Vitreoretin Dis. 2020 Aug 13;4(6):509-514. doi: 10.1177/2474126420936586. eCollection 2020 Nov-Dec.
PURPOSE
This work describes the characteristics and unique features of ocular syphilis.
METHODS
Ten serologically proven cases of ocular syphilis were retrospectively analyzed.
RESULTS
Eighteen eyes of 10 patients were affected. Nine of 10 patients were male and the mean age was 58 years (range, 36-81 years). HIV antibody testing was positive in 3 patients (30%). Five cases were first diagnosed by an ophthalmologist. One patient presented with a syphilitic rash. The most common ocular findings were panuveitis (n = 6) and cystoid macular edema (n = 4). Ocular involvement was unilateral in 2 cases and bilateral in 8. Best-corrected visual acuity improved in 13 of 18 eyes (72%) after treatment. Three cases developed recurrent retinal detachments that required repair with silicone oil.
CONCLUSIONS
Most cases were HIV negative. Syphilitic uveitis can be the initial presentation of syphilis without classic systemic manifestation. Ophthalmologists play an important role in the diagnosis and treatment of syphilis.
目的
本研究描述了眼梅毒的特征和独特表现。
方法
对10例血清学确诊的眼梅毒病例进行回顾性分析。
结果
10例患者的18只眼受累。10例患者中有9例为男性，平均年龄为58岁（范围36 - 81岁）。3例患者（30%）HIV抗体检测呈阳性。5例最初由眼科医生诊断。1例患者出现梅毒疹。最常见的眼部表现为全葡萄膜炎（n = 6）和黄斑囊样水肿（n = 4）。2例眼部受累为单侧，8例为双侧。治疗后18只眼中有13只（72%）最佳矫正视力提高。3例发生复发性视网膜脱离，需要用硅油修复。
结论
大多数病例HIV检测为阴性。梅毒性葡萄膜炎可能是梅毒的首发表现，而无典型的全身表现。眼科医生在梅毒的诊断和治疗中起重要作用。
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