CAJ | 학술논문

目的:评估梅毒性葡萄膜炎患者的临床表现和视力.方法:梅毒性葡萄膜炎患者3例在USM医院接受治疗.结果:患者3例被诊断为继发性梅毒性葡萄膜炎,这3例患者患病之前均不知道患有梅毒,但他们有明确的乱交史.并且每个月都伴有逐步的视力下降.其中两人伴有发热、跟痛、眼前悬浮物.视力从6/12到手动.所有患者均出现前葡萄膜炎,玻璃体炎和视神经炎.第一例患者出现了多灶性脉络膜视网膜炎,并伴有渗出性视网膜脱离.第二例患者出现渗出性视网膜脱离,而第三例患者仅出现了脉络膜视网膜炎.所有患者每周注射苄青霉素2.4MU,共4wk,其中2例患者口服多西霉素200mg 2次/d,共3mo.治疗效果良好,其中2例患者有显著的视力上升,分别从6/120到6/21和6/12到6/6.其中较严重的1例患者出现逆转录酶为阳性.结论:眼梅毒作为非肉芽肿性的炎症与渗出性视网膜脱离有关.治疗后虽然视力恢复比较缓慢,但普遍有良好的效果.
목적:평고매독성포도막염환자적림상표현화시력.방법:매독성포도막염환자3례재USM의원접수치료.결과:환자3례피진단위계발성매독성포도막염,저3례환자환병지전균불지도환유매독,단타문유명학적란교사.병차매개월도반유축보적시력하강.기중량인반유발열、근통、안전현부물.시력종6/12도수동.소유환자균출현전포도막염,파리체염화시신경염.제일례환자출현료다조성맥락막시망막염,병반유삼출성시망막탈리.제이례환자출현삼출성시망막탈리,이제삼례환자부출현료맥락막시망막염.소유환자매주주사변청매소2.4MU,공4wk,기중2례환자구복다서매소200mg 2차/d,공3mo.치료효과량호,기중2례환자유현저적시력상승,분별종6/120도6/21화6/12도6/6.기중교엄중적1례환자출현역전록매위양성.결론:안매독작위비육아종성적염증여삼출성시망막탈리유관.치료후수연시력회복비교완만,단보편유량호적효과.
·AIM: To evaluate the clinical manifestations and visual outcome of syphilitic uveitis patients. ·METHODS: Case series of three patients with syphilitic uveitis were managed in Hospital USM.·RESULTS: Three patients were diagnosed to have uveitis secondary to syphilis. All three patients were not known to have syphilis prior to presentation but had positive history of sexual promiscuity. All patients presented with progressive blurring of vision for average of one-month duration. Two of them had association with fever, ocular pain and floaters. Visual acuity at presentation ranged from 6/12 to hand movement. Mild anterior uveitis ( non-granulomatous), vitritis and papillitis were present in all the patients. First patient had multifocal chorioretinitis with exudative retinal detachment. The second patient presented with exudative retinal detachment while the third patient had chorioretinitis only. All the patients were treated with intramuscular benzyl-penicillin 2.4 MU weekly for 4 weeks and two of them received oral doxycycline 200mg twice daily for 3 months. The uveitis responded well to the treatment and two of them showed dramatic visual improvement from 6/120 to 6/21 and 6/12 to 6/6. The one with worse outcome was confirmed to have positive retroviral.·CONCLUSION: Ocular syphilis presented here as non granulomatous inflammation associated with exudative retinal detachment, Final visual outcome is generally good despite slow improvement after treatment.