Comastri Lucia, Heredia Milagros, Bar Diego, Iribarren Guillermo, Schlaen Ariel
Hospital Alemán, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Hospital Universitario Austral, Derqui-Pilar, Buenos Aires, Argentina.
Case Rep Ophthalmol. 2023 Jul 3;14(1):267-273. doi: 10.1159/000530876. eCollection 2023 Jan-Dec.
We report the findings observed in a young woman with ocular syphilis complicated with retinal and disc neovascularization successfully treated with intravitreal bevacizumab. Fluorescein angiography revealed in both eyes intense hyperfluorescence at the level of the disc, multifocal venous wall staining, multifocal paravenous leakage, multiple peripheral saccular venular dilations, diffuse retinal and macular edema, and retinal and disc neovascularization. There was no evidence of retinal ischemia in both eyes. After antibiotic and corticosteroid treatment, the neovascularization persisted in both eyes. Three consecutive doses of intravitreal bevacizumab were administered, with total regression of the retinal and disc neovascularization. Disc and retinal neovascularization along with nonocclusive retinal vasculitis may be a form of presentation of ocular syphilis. Combination of specific treatment, oral corticosteroids, and intravitreal bevacizumab may be useful for treating this clinical manifestation.
我们报告了一名患有眼部梅毒并伴有视网膜和视盘新生血管形成的年轻女性患者的观察结果,该患者经玻璃体内注射贝伐单抗成功治疗。荧光素血管造影显示双眼视盘水平有强烈的高荧光、多灶性静脉壁染色、多灶性静脉旁渗漏、多个周边囊状小静脉扩张、弥漫性视网膜和黄斑水肿以及视网膜和视盘新生血管形成。双眼均无视网膜缺血的证据。抗生素和皮质类固醇治疗后,双眼新生血管形成持续存在。连续三次玻璃体内注射贝伐单抗后,视网膜和视盘新生血管完全消退。视盘和视网膜新生血管形成以及非闭塞性视网膜血管炎可能是眼部梅毒的一种表现形式。特异性治疗、口服皮质类固醇和玻璃体内注射贝伐单抗联合应用可能有助于治疗这种临床表现。