Williams J K, Kirsch L S, Russack V, Freeman W R
Department of Ophthalmology, University of California at San Diego, La Jolla 92093-0946, USA.
Ophthalmic Surg Lasers. 1996 Aug;27(8):699-705.
The purpose of this study is to report retinal manifestations of lues in human immunodeficiency virus (HIV)-positive patients and to suggest a method for treatment of rhegmatogenous retinal detachments in these patients. Two HIV-positive patients with bilateral retinitis were examined and treated at the authors' institution for a period of 14 months. Ocular syphilis was diagnosed clinically, confirmed by cerebrospinal fluid serologic testing, and treated with intravenous penicillin. Both patients experienced bilateral rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy after resolution of the active retinitis. All four eyes underwent surgical repair with trans pars plana vitrectomy, epiretinal membrane delamination, gas-fluid exchange, endolaser, scleral buckle, and silicone oil instillation. The recognition of ocular syphilis as a cause of retinal detachment in HIV-positive patients is important. Prompt intervention with the appropriate medical and surgical treatments may result in the preservation of vision in these patients.
本研究的目的是报告人类免疫缺陷病毒（HIV）阳性患者梅毒的视网膜表现，并提出一种治疗这些患者孔源性视网膜脱离的方法。两名患有双侧视网膜炎的HIV阳性患者在作者所在机构接受了为期14个月的检查和治疗。眼部梅毒通过临床诊断，经脑脊液血清学检测确诊，并接受静脉注射青霉素治疗。两名患者在活动性视网膜炎消退后均出现双侧孔源性视网膜脱离，并伴有增殖性玻璃体视网膜病变。所有四只眼睛均接受了经扁平部玻璃体切除术、视网膜前膜分层、气液交换、眼内激光、巩膜扣带术和硅油注入的手术修复。认识到眼部梅毒是HIV阳性患者视网膜脱离的一个病因很重要。及时进行适当的药物和手术治疗干预可能会使这些患者的视力得以保留。
