141例神经梅毒患者眼部表现的临床分析  

Ophthalmological manifestations of neurosyphilis in 141 cases

作　　者：王胜男 孙挥宇 毛菲菲 李丹 鲁丹 刘夕瑶 Wang Shengnan;Sun Huiyu;Mao Feifei;Li Dan;Lu Dan;Liu Xiyao(Department of Ophthalmology,National Clinical Key Department of Infections Disease,Beijing Institute of Infectious Diseases of Combination of Chinese Traditional and Western Medicine,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院眼科感染病科国家临床重点专科,北京市中西医结合感染性疾病研究所,100015

出　　处：《眼科》2021年第5期386-390,共5页Ophthalmology in China

摘　　要：目的分析神经梅毒患者眼部表现特征。设计回顾性病例系列。研究对象2016-2019年北京地坛医院眼科神经梅毒患者141例(282眼)。方法回顾患者的病历资料,包括最佳矫正视力、裂隙灯显微镜检查、眼压、眼位、眼球运动及眼底检查结果等,描述并分析其临床特征。主要指标最佳矫正视力、瞳孔、视神经、视网膜脉络膜改变以及与眼球运动相关的颅神经病变等。结果141例神经梅毒患者中有眼部表现者74例(52.5%)(127眼)。瞳孔异常者61例(43.3%)(107眼),其中18例(33眼)以Argyll-Robertson瞳孔为唯一表现,6例(8眼)以Adie瞳孔为唯一表现。葡萄膜炎35例(24.8%)(61眼),麻痹性斜视7例(5.0%)(8眼),视神经病变6例(4.3%)(11眼),梅毒性巩膜炎2例(1.4%)(2眼)。结论神经梅毒相关眼病临床表现多样,最常发生瞳孔改变和累及视神经的葡萄膜炎。Objective To investigate the characteristics of ophthalmic manifestation of patients with neurosyphilis.Design Retrospective case series.Participants 141 cases(282 eyes) of neurosyphilis patients admitted to Beijing Ditan Hospital in 2016-2019.Methods Medical records of all patients data were reviewed,including best corrected visual acuity,slit lamp,intraocular pressure,ocular position,eye movement and fundus examination.Clinical manifestations and imaging characteristics of patients were reviewed.Main Outcome Measures Best corrected visual acuity,pupil,optic nerve,retinal choroidal changes and neuropathy associated with ocular movement.Results In all 141 cases(282 eyes),74 cases(52.5%)(127 eyes) had ocular manifestations,of which pupil abnormalities(43.3%)were the most common,including Argyll-Robertson pupil was the only clinical manifestation in 18 cases(33 eyes) and Adie pupil was the only clinical manifestation in 6 cases(8 eyes).35 cases(24.8%)(61 eyes) expressed as uveitis and ophthalmoplegia was found in 7 cases(5.0%)(8 eyes).6 cases(4.3%)(1 1 eyes) expressed as optic neuropathy.Syphilitic scleritis was found in 2 cases(1.4%)(2 eyes).Conclusion The characteristics of ophthalmic manifestation of patients with neurosyphilis are various.The common manifestations are pupil change and uveitis involving optic nerve.

关 键 词：神经梅毒 眼感染 

分 类 号：R759.13[医药卫生—皮肤病学与性病学] R771.3[医药卫生—临床医学]