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4例梅毒性视网膜外层病变患者的临床特征。

Clinical features in four patients with syphilitic outer retinopathy.

作者信息

Oga Tomoyuki, Kuniyoshi Kazuki, Sugino Akihiko, Sato Tomoko, Mano Fukutaro, Sakamoto Masuo, Iwahashi Chiharu, Sugioka Koji, Kusaka Shunji

机构信息

Department of Ophthalmology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan.

Department of Ophthalmology, Kindai University Nara Hospital, Ikoma, Japan.

出版信息

Jpn J Ophthalmol. 2025 Apr 11. doi: 10.1007/s10384-025-01191-6.

Abstract

PURPOSE

To present the clinical findings of patients diagnosed with syphilitic outer retinopathy.

STUDY DESIGN

A retrospective clinical study.

PATIENTS AND METHODS

The study involved four Japanese men whose medical charts were reviewed and analyzed retrospectively.

RESULTS

All patients declined decimal visual acuity to 0.1, 0.2, 0.4, 0.6, and 0.8. Their fundus appearances were generally normal, except for one patient who displayed faint white dots in the upper macular region. Two patients showed dye leakage from retinal vessels during fluorescein angiography. Optical coherence tomography (OCT) results revealed abnormalities in all patients: three had a disrupted ellipsoid zone (EZ) and hyper-reflective nodules at the retinal pigment epithelium line, while one patient presented with a blurred EZ. The patients had myopia ranging from -4.5 to -7.5 diopters. They were diagnosed with syphilitic outer retinopathy based on the findings from the fundus examination, OCT, and serologic tests and were treated with oral amoxicillin, resulting in improved vision.

CONCLUSIONS

The OCT findings are typical for diagnosing syphilitic outer retinopathy. Myopia was prevalent in the four patients, indicating a need for further research on refractive errors in patients with syphilitic outer retinopathy.

摘要

目的

介绍被诊断为梅毒性外层视网膜病变患者的临床特征。

研究设计

一项回顾性临床研究。

患者与方法

该研究纳入了4名日本男性患者,对其病历进行回顾性分析。

结果

所有患者的小数视力均下降至0.1、0.2、0.4、0.6和0.8。除1例患者在黄斑区上方出现淡白色小点外,他们的眼底表现总体正常。2例患者在荧光素血管造影时显示视网膜血管渗漏。光学相干断层扫描(OCT)结果显示所有患者均有异常:3例患者的椭圆体带(EZ)中断,视网膜色素上皮线处有高反射结节,1例患者的EZ模糊。患者的近视度数在-4.5至-7.5屈光度之间。根据眼底检查、OCT和血清学检查结果,他们被诊断为梅毒性外层视网膜病变,并接受口服阿莫西林治疗,视力得到改善。

结论

OCT检查结果是诊断梅毒性外层视网膜病变的典型表现。这4例患者中近视较为普遍,提示需要对梅毒性外层视网膜病变患者的屈光不正进行进一步研究。

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