Bilateral retrocorneal hyaline scrolls secondary to asymptomatic congenital syphilis: A case report  

作　　者：Yu-Qi Jin Yong-Ping Hu Qi Dai Shuang-Qing Wu 

机构地区：[1]Department of Ophthalmology,Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang Province,China [2]The Center of Cornea and Refraction,The Eye Hospital of Wenzhou Medical University,Hangzhou 325027,Zhejiang Province,China [3]Department of Ophthalmology,Zhejiang Provincial Integrated Chinese and Western Medicine Hospital,Hangzhou 310003,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2021年第10期2274-2280,共7页世界临床病例杂志

基　　金：Zhejiang Provincial Medical and Health Technology Project,No.2020KY215.

摘　　要：BACKGROUND Retrocorneal hyaline scrolls are a rare phenomenon.We report a case of bilateral retrocorneal hyaline scrolls that were likely induced by asymptomatic congenital syphilis.CASE SUMMARY A 71-year-old woman presented with blurred vision due to cataracts.Slit-lamp microscopy revealed bilateral hyaline scrolls with a dichotomous branching pattern extending to the anterior chamber or rods attaching to the rough posterior surface of the cornea.The patient was positive for syphilis-specific antibodies,with no ocular or systemic evidence of congenital or acquired syphilis.Binocular cataract,retrocorneal scroll,and corneal endothelial gutta were considered.The scroll of the right eye was removed during cataract surgery and further observed using hematoxylin–eosin staining and scanning electron microscopy.The cornea of the right eye remained transparent,and the residual scroll seemed stable,however,the corneal endothelial density declined at 13 mo after surgery.In vivo confocal microscopy revealed coalescence of corneal guttae at the level of the corneal endothelium or adhesion to the posterior surface of the endothelium,with enlarged endothelial cells in both eyes.Activated keratocytes in the stroma and a highly reflective acellular structure at the level of the Descemet’s membrane were observed.The removed scroll had a cartilage-like hardness and a circularly arranged fiber-like acellular structure.CONCLUSION Occult congenital syphilis could induce corneal endothelial gutta and theformation of retrocorneal scrolls without other signs of ocular syphilis.

关 键 词：SCROLL Corneal endothelium Congenital syphilis Syphilitic interstitial keratitis In vivo confocal microscopy Case report 

分 类 号：R772.2[医药卫生—眼科] R759.1[医药卫生—临床医学]