HIV阳性梅毒性葡萄膜炎慢性迁延期1例  

HIV positive syphilis uveitis on chronic stage:a case report

作　　者：马娜 汪朝阳 陈春丽 Ma Na;Wang Chaoyang;Chen Chunli(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Beijing 100730,China;Rizhao Ophthalmology Hospital,Rizhao Traditional Chinese Medicine Hospital,Rizhao 276800,China)

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心、北京市眼科研究所、北京市眼科学与视觉科学重点实验室,北京100730 [2]日照市中医医院日照市眼科医院,日照276800

出　　处：《中华眼科杂志》2025年第3期211-214,共4页Chinese Journal of Ophthalmology

摘　　要：患者男性,39岁。因双眼视力下降1年余就诊。既往人免疫缺陷病毒感染10余年,曾在当地医院诊断为双眼视盘血管炎、双眼全葡萄膜炎,给予全身糖皮质激素冲击、口服糖皮质激素及免疫抑制剂治疗半年余未见好转。来诊后完善全身及眼部检查,相干光层析成像示双眼视网膜外层结构中断缺失、黄斑水肿,荧光素眼底血管造影术示弥漫点状透见荧光及血管渗漏,快速梅毒血清素反应结果为1∶64,诊断为双眼梅毒性葡萄膜炎。抗病毒治疗3周后,予口服糖皮质激素序贯减量治疗,患者病情控制,视力恢复。A 39-year-old male patient presented with"decreased bilateral visual acuity for more than one year".He has been infected with human immunodeficiency virus(HIV)for more than 10 years,and was diagnosed as"binocular panuveitis""binocular optic disc vasculitis"in the local hospital,with no improvement after six months of systemic hormone shock,intermittent oral hormone and immunosuppressive treatment.Comprehensive examinations were conducted after arrival,Optical coherence tomography revealed the damage of posterior retina,macular edema,fluorescein fundus angiography showed diffuse punctate transmitted fluorescence and vascular leakage,rapid syphilis serotonin response(RPR)1∶64,leading to the diagnosis of binocular syphilitic uveitis.After three weeks of antibiotic treatment,oral hormone sequential reduction treatment,disease control,vision recovery.

关 键 词：梅毒 葡萄膜炎 HIV血清阳性 

分 类 号：R65[医药卫生—外科学]