梅毒性葡萄膜炎的临床特征分析  

Clinical analysis of syphilitic uveitis

作　　者：申然[1] 王浩[2] 杨丽萍[1] 杨林青[1] 季红英[1] 娄增新[1] 郭黎霞[1] 段志娟[1] 

机构地区：[1]河北省邯郸市眼科医院,邯郸056001 [2]中南大学爱尔眼科学院,长沙410000

出　　处：《中国中医眼科杂志》2016年第3期174-177,共4页China Journal of Chinese Ophthalmology

摘　　要：目的总结分析梅毒性葡萄膜炎的临床特征和眼底表现。方法回顾分析2010年2月至2015年4月在我院诊断为梅毒性葡萄膜炎的患者16人（27眼）的临床资料,对其病史、眼科检查、辅助检查以及治疗、随访情况进行分析。结果 16人中男性9人,女性7人。发病年龄35~60岁,19眼有轻微的眼前节炎症反应,占70.37%,24眼有不同程度的玻璃体混浊、玻璃体浮游物,占88.89%,18眼有视盘充血,占66.67%,其中8眼伴有视盘水肿,7眼存在视网膜黄白色团块状、舟状渗出,占25.92%,6眼有视网膜片状出血,占22.22%,1眼出现黄斑囊样水肿占3.70%。21眼行荧光素眼底血管造影检查,均有不同程度的视网膜血管渗漏、视盘染色,8眼在造影早期有斑片状低荧光,7眼晚期视网膜有大片荧光素染色。患者接受青霉素治疗后病情可得到缓解。结论梅毒性葡萄膜炎的病变以眼后段为主,其视力预后与其治疗前的病变程度有关。OBJECTIVE To summarize the features including fundus change of patients with syphilitic uveitis. METHODS We retrospectively reviewed the clinical data of 16 syphilitic uveitis patients who visited our hospital between 2010 and 2015. Medical data involving history, ocular examination, auxiliary examination, treatment and follow-up were studied. RESULTS Sixteen patients included 9 males and 7 females. Their age of onset ranged from 35 to 60. Mild inflammation was found in 19 eyes（70.37%）, and different levels of vitreous opacity and floater was observed in 24 eyes（88.89%）. And 18 eyes（66.67%） suffered from optic disc hyperemia, among which 8eyes endured optic disc edema. Retina examination showed that 7 eyes（25.92%） had yellow-white mass or boatshaped exudation, 6 eyes（22.22%） went through patchy hemorrhage and macular cystoid edema happened in 1 eye（3.70%）. The FFA was performed in 21 eyes and found blood vessel leakage and optic head staining in all of therm.Low patchy fluorescence was seen in 8 eyes in their early phase, while hyperfluorescence was observed in 7 eyes in their late phase. All the patients relieved after administration of penicillin. CONCLUSIONS Syphilitic uveitis mainly involves the posterior segment of the eye. Proper diagnosis and treatment could help curing the disease, but the visual prognosis is related to the severity of the inflammation before treatment.

关 键 词：梅毒 葡萄膜炎 黄斑水肿 渗出 玻璃体混浊 

分 类 号：R773.9[医药卫生—眼科]