眼梅毒,急性后placoid脉络膜视网膜炎1例。

M C Veys, B Lafaut
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引用次数: 0

摘要

目的:报告1例眼梅毒的罕见表现——急性后placoid脉络膜视网膜炎。方法:患者年龄59岁,有右眼亚急性严重单侧视力丧失症状。他接受了眼底检查、自动视野检查、光学相干断层成像和荧光素血管造影。随访3个月。结果:发病时,右眼视敏度为手部运动。眼底检查显示视网膜中央placoid淡黄色病变,病变范围超过颞血管拱廊。光学相干断层扫描显示神经视网膜增厚,内外节连接处消失。荧光素血管造影显示早期低荧光区,随后是高荧光区和晚期染色区。血清学检查为二期梅毒阳性。静脉注射头孢曲松2g/d治疗2周后,功能完全恢复,眼底病变消退。结论:急性梅毒性后placoid脉络膜视网膜炎是梅毒患者中一种罕见的脉络膜视网膜表现。这种疾病的发病机制尚不清楚。由于眼梅毒没有病理特征,其表现可能与其他疾病相似。保持对这种疾病的不同表现的认识,使眼科医生在梅毒的早期诊断中发挥关键作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ocular syphilis, a case of acute posterior placoid chorioretinitis.

Purpose: To report a case of acute posterior placoid chorioretinitis, a rare manifestation of ocular syphilis.

Methods: The patient was examined at age 59 with symptoms of subacute severe unilateral vision loss of the right eye. He underwent fundus examination, automated perimetry, optical coherence tomography imaging and fluorescein angiography. There was a close follow-up for 3 months.

Results: At time of presentation, the visual acuity in the right eye was hand movement. Fundus examination showed a central retinal placoid yellowish lesion going beyond the temporal vascular arcades. Optical coherence tomography showed thickening of the neuroretina and disappearance of the inner and outer segment junction. Fluorescein angiography showed in the early phase areas of hypofluorescence followed by hyperfluorescence and late staining. Serologic examinations were positive for secondary syphilis. After treatment with intravenous ceftriaxone 2g/d for 2 weeks there was a complete functional recovery with regression of the fundus lesion.

Conclusions: Acute syphilitic posterior placoid chorioretinitis has been described as a rare chorioretinal manifestation in patients with syphilis. The pathogenesis of this entity still remains unknown. Since there are no pathognomonic features of ocular syphilis, findings may often mimic those of other diseases. Maintaining an awareness of the different manifestations of this disease allows ophthalmologists to play a key role in the early diagnosis of syphilis.

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