Ronnie Abhishek Talluri, Kelgaonkar Anup, Jadhav Vishal, Patel Anamika, Tyagi Mudit, Basu Soumyava, Pathengay Avinash
Uveitis, Vitreous and Retina Service, LV Prasad Eye Institute, Bhubaneswar, India.
Uveitis, Vitreous and Retina Service, LV Prasad Eye Institute, Visakhapatnam, India.
Ocul Immunol Inflamm. 2025 Jan;33(1):80-85. doi: 10.1080/09273948.2024.2358996. Epub 2024 Jun 3.
To study clinical characteristics and management outcomes of cases of ocular syphilis co-presenting with scleritis and active uveitis.
A retrospective analysis of cases diagnosed with ocular syphilis between January 2020 and December 2023 was conducted at a tertiary eye care centre. Clinical records, investigations, and outcomes were reviewed to identify cases with scleritis with active uveitis. Demographic data, clinical features, treatment modalities, and resolution patterns were analyzed.
Among the 135 eyes of 95 cases of ocular syphilis studied, scleritis with uveitis was observed in 3.70% of eyes (five eyes). All cases with scleritis and uveitis were unilateral and male, with ages ranging from 32 to 61 years. Concurrent features included placoid chorioretinitis, retinal vasculitis, and anterior uveitis. Misdiagnosis with subsequent oral steroid therapy precipitated scleritis as an exacerbation in two cases. Three cases, which were previously undiagnosed, were found to be HIV-positive. Scleritis manifested as anterior, non-necrotizing inflammation, often accompanied by chemosis, and responded rapidly to antibiotic and non-steroidal anti-inflammatory therapy. Scleritis resolution preceded that of chorioretinitis and retinal vasculitis.
Non-necrotizing anterior scleritis with chemosis can be a rare presentation of active syphilitic uveitis. Large placoid chorioretinitis lesions, preceding inadvertent oral steroid and/or undiagnosed HIV status were the possible risk factors for the development of concurrent scleritis.
研究合并巩膜炎和活动性葡萄膜炎的眼梅毒病例的临床特征及治疗效果。
在一家三级眼科护理中心对2020年1月至2023年12月期间诊断为眼梅毒的病例进行回顾性分析。对临床记录、检查及治疗结果进行审查，以确定合并活动性葡萄膜炎的巩膜炎病例。分析人口统计学数据、临床特征、治疗方式及恢复模式。
在研究的95例眼梅毒患者的135只眼中，3.70%的眼睛（5只眼）出现了合并葡萄膜炎的巩膜炎。所有合并巩膜炎和葡萄膜炎的病例均为单眼且为男性，年龄在32至61岁之间。并发特征包括地图状脉络膜视网膜病变、视网膜血管炎和前葡萄膜炎。两例因误诊后口服类固醇治疗导致巩膜炎加重。3例之前未被诊断出的病例被发现为HIV阳性。巩膜炎表现为前部非坏死性炎症，常伴有结膜水肿，对抗生素和非甾体抗炎治疗反应迅速。巩膜炎的消退早于脉络膜视网膜病变和视网膜血管炎。
伴有结膜水肿的非坏死性前部巩膜炎可能是活动性梅毒性葡萄膜炎的一种罕见表现。大面积地图状脉络膜视网膜病变、无意中使用口服类固醇和/或未诊断出的HIV感染状态可能是并发巩膜炎发生的危险因素。
