Amaral Claudia, Joy Leilani, Jimenez Hiram, Cruz-Inñigo Yousef J, Ulloa-Padilla Jan P, Oliver Armando L
University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, PR, USA.
Department of Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, USA.
J Vitreoretin Dis. 2021 Jun 21;6(1):63-70. doi: 10.1177/24741264211018300. eCollection 2022 Jan-Feb.
This work presents a case of syphilitic outer retinopathy with findings similar to those of acute zonal occult outer retinopathy (AZOOR). We also discuss the clinical characteristics, treatment, and prognosis of this entity.
A case report and systematic literature review are presented.
A 56-year-old woman presented with acute vision loss, localized photopsia, a central scotoma, and retinal findings that were all consistent with AZOOR. A further workup led to a diagnosis of syphilis. Oral prednisone and intravenous penicillin resulted in the resolution of the posterior uveitis and the restoration of visual acuity. However, the central scotoma remained at the 3-year follow-up visit.
Syphilitic outer retinopathy is a distinct entity characterized by the disruption of the ellipsoid zone visible on optical coherence tomography and a corresponding increase in fundus hyperautofluorescence in the affected areas. Although some patients may present with a demarcation line, as is seen with AZOOR, the fundus is oftentimes unremarkable or may show only subtle retinal pigment epithelium changes. Uveitis resolution and visual acuity restoration may be expected following treatment; however, visual field disturbances may persist.
本文报告一例梅毒相关性外层视网膜病变，其表现与急性区域性隐匿性外层视网膜病变（AZOOR）相似。我们还将讨论该疾病的临床特征、治疗及预后。
本文呈现了一例病例报告及系统的文献综述。
一名56岁女性患者出现急性视力丧失、局限性闪光感、中心暗点，其视网膜表现均与AZOOR相符。进一步检查诊断为梅毒。口服泼尼松及静脉注射青霉素后，后葡萄膜炎消退，视力恢复。然而，在3年随访时中心暗点仍存在。
梅毒相关性外层视网膜病变是一种独特的疾病，其特征为光学相干断层扫描可见椭圆体带中断，且受累区域眼底自发荧光增强。尽管部分患者可能出现与AZOOR相似的分界线，但眼底通常无明显异常，或仅表现为视网膜色素上皮的细微改变。治疗后葡萄膜炎可能消退，视力有望恢复；然而，视野障碍可能持续存在。
