Ruder A J, Halverson K D, Austin J K, Jones W L
J Am Optom Assoc. 1993 Apr;64(4):245-9.
A 59-year-old black male presented with an acute unilateral central scotoma and decreased visual acuity in each eye. Ocular examination revealed bilateral vitritis, nerve fiber layer hemorrhages and infarcts, arteritis, serous macular edema and optic nerve head edema with telangiectasia. Vascular work-up was remarkable for a reactive FTA-ABS, VDRL and RPR. Lymphocytes, monocytes, basophils and platelet count were elevated. HIV tests were nonreactive. Ocular, serologic and cerebrospinal fluid findings along with past sexual history were consistent with a diagnosis of early neurosyphilis. Prompt referral to an infectious disease physician and subsequent treatment with parenteral penicillin resulted in complete resolution of the vitreoretinitis.
一名59岁的黑人男性出现急性单侧中央暗点，且每只眼睛的视力均下降。眼部检查发现双侧玻璃体炎、神经纤维层出血和梗死、动脉炎、浆液性黄斑水肿以及伴有毛细血管扩张的视神经乳头水肿。血管检查显示荧光密螺旋体抗体吸收试验（FTA-ABS）、性病研究实验室试验（VDRL）和快速血浆反应素环状卡片试验（RPR）呈反应性。淋巴细胞、单核细胞、嗜碱性粒细胞和血小板计数升高。艾滋病毒检测呈阴性。眼部、血清学和脑脊液检查结果以及既往性病史均符合早期神经梅毒的诊断。迅速转诊至传染病科医生处，随后接受肠胃外青霉素治疗，玻璃体视网膜炎完全消退。
