Syphilitic uveitis in HIV-positive patients: report of a case series, treatment outcomes, and comprehensive review of the literature  

作　　者：Ning Xu Jia-Guo Yuan Qin-Jin Dai Chao Yuan Yan He Ting-Shuai Jiang Jie Zhu 

机构地区：[1]Guangzhou Twelfth People’s Hospital,Guangzhou Medical University,Guangzhou 510620,Guangdong Province,China [2]Guangzhou Eighth People’s Hospital,Guangzhou Medical University,Guangzhou 510440,Guangdong Province,China [3]Guangzhou Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou 510623,Guangdong Province,China [4]Xijing Hospital,Fourth Military Medical University,Xi’an 710032,Shaanxi Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2023年第8期1250-1259,共10页国际眼科杂志（英文版）

基　　金：Supported by the“Zhujiang Talent Program”High Talent Project of Guangdong Province(No.2019QN01Y162);the Natural Science Foundation of Guangdong Province(No.2020A1515010072,No.2023A1515010167)。

摘　　要：AIM:To report the clinical characteristics,treatment and outcomes of active syphilitic uveitis in human immunodeficiency virus(HIV)positive patients and compare them with the previously published data.METHODS:Retrospective analysis of the case series from an infectious disease center in southern China was conducted.Comprehensive review of previously published cases of HIV positive syphilitic uveitis was conducted using the PubMed and Web of Science databases and the references listed in the identified articles.RESULTS:Twelve HIV positive patients with active syphilitic uveitis were collected.All were male,with age of 36.3y(range 27 to 53y).Five(41.7%)had a history of syphilis,and three of them had received anti-syphilis treatment.Ocular manifestations included corneal epithelial defect(13%),complicated cataract(17.4%),vitreous opacity(82.6%),optic disc edema(26.1%),macular edema(30.4%),neuro-retinitis(43.5%),and retinal hemorrhage(26.1%).After standardized syphilitic treatment,intraocular inflammation was reduced and vision improved in all cases.The literature review summarizes 105 previously reported cases of HIV positive syphilitic uveitis.High serum rapid plasma regain(RPR)titers may be associated with severe uveitis and poor vision.Treatment with penicillin,ceftriaxone sodium,or penicillin plus benzylpenicillin instead of using benzylpenicillin alone can significantly improve bestcorrected visual acuity(BCVA)in HIV positive ocular syphilis patients.CONCLUSION:For HIV positive syphilitic uveitis patients,prompt diagnosis and appropriate treatment and follow-up are paramount.In our series,the clinical manifestations are diverse.Syphilis patients treated by penicillin G or long-acting penicillin before may still develop syphilitic uveitis.Patients who relapse after long-term penicillin treatment can still benefit from penicillin G.

关 键 词：SYPHILIS UVEITIS human immunodeficiency virus neurosyphilis regimen literature review 

分 类 号：R773[医药卫生—眼科] R512.91[医药卫生—临床医学]