Arruga J, Valentines J, Mauri F, Roca G, Salom R, Rufi G
Ophthalmology. 1985 Feb;92(2):262-70. doi: 10.1016/s0161-6420(85)34045-9.
Syphilitic disease of the retina and/or the optic nerve head, without choroidal involvement, occurred in our 4 cases and in another 19 cases. The condition almost always takes place in the secondary stage, frequently associated with meningitis, and rarely in tertiary meningovascular syphilis. Fluctuating visual loss and floating spots without ocular pain are the presenting symptoms. Retinitis, papillitis, and neuroretinitis are accompanied by an inflammatory reaction in the vitreous and, sometimes, in the aqueous. Paracentral scotomas and blind spot enlargement, related with posterior pole and papillary edema, are the most usual visual field defects. Almost complete visual recovery is the rule in the treated cases, although in some instances cystoid macular edema and retinal ischemia due to endarteritis cause permanent visual loss. Treatment with crystalline penicillin is mandatory in patients with concomitant neurosyphilis, whereas procaine penicillin is seemingly sufficient in those with a normal cerebral spinal fluid examination.
我们的4例以及另外19例患者出现了视网膜和/或视神经乳头的梅毒疾病，不累及脉络膜。这种情况几乎总是发生在二期，常与脑膜炎相关，很少见于三期脑膜血管梅毒。视力波动下降和眼前有漂浮物且无眼痛是主要症状。视网膜炎、视乳头炎和神经视网膜炎伴有玻璃体、有时还有房水的炎症反应。与后极和视乳头水肿相关的旁中心暗点和盲点扩大是最常见的视野缺损。在接受治疗的病例中，几乎都能完全恢复视力，尽管在某些情况下，囊样黄斑水肿和动脉内膜炎导致的视网膜缺血会造成永久性视力丧失。对于合并神经梅毒的患者，必须使用结晶青霉素进行治疗，而对于脑脊液检查正常的患者，普鲁卡因青霉素似乎就足够了。
