梅毒性视神经炎诊断和治疗专家共识(2022)

Expert consensus on diagnosis and treatment of syphilitic optic neuritis(2022)

2014年,中华医学会眼科学分会神经眼科学组制定了《视神经炎诊断和治疗专家共识》,指出感染性和感染相关性视神经炎是视神经炎的一个重要病因分型。近年来梅毒发病率逐年升高,2016年我国梅毒发病率为32.2/10万。梅毒性视神经炎(SON)已成为眼科医师不容忽视的一类感染性视神经炎。SON由苍白密螺旋体侵犯视神经及其周围鞘膜引起,是眼梅毒和神经梅毒的一部分。SON临床表现具有多变性,可以模仿各种感染性或自身免疫性视神经疾病,被称为"万能模仿者",其误诊率和漏诊率均较高。因此,中华医学会眼科学分会神经眼科学组组织专家组成员在全国范围内对SON患者诊疗中存在的临床问题和困难进行广泛调查和归纳,以邮件和线上会议的形式组织专家组成员进行反复讨论,经过1年多的反复修订制定出了SON诊断和治疗专家共识,着重介绍SON的临床表现、诊断标准、治疗和随访方案,对此病规范化诊治的推广有重要指导作用。

In 2014,the Neuro-Ophthalmology Group of the Chinese Ophthalmological Society of the Chinese Medical Association formulated the Expert Consensus on the Diagnosis and Treatment of Optic Neuritis,pointing out that infectious and infection-related optic neuritis is an important etiological type of optic neuritis.In recent years,the incidence of syphilis has been increasing year by year.In 2016,the incidence of syphilis in China was 32.2/100000.Syphilitic optic neuritis(SON)has become a type of infectious optic neuritis that cannot be ignored by ophthalmologists.SON is caused by Treponema pallidum invading the optic nerve and its surrounding sheath,and is a part of ocular syphilis and neurosyphilis.The clinical manifestations of SON are variable and can imitate various infectious or autoimmune optic nerve diseases.SON is called universal imitator,and its misdiagnosis rate and omission diagnosis rate are relatively high.Therefore,the Neuro-Ophthalmology Group of the Chinese Ophthalmological Society of the Chinese Medical Association organized the members of the expert group to extensively investigate and summarize the problems and difficulties existing in the diagnosis and treatment of SON patients in clinical practice nationwide via emails and online meetings.After many discussions and more than one year of repeated revisions,an expert consensus on the diagnosis and treatment of SON was formulated,focusing on the clinical manifestations,diagnostic criteria,treatment plans and follow-up of SON,which provides important guidance for the promotion of standardized diagnosis and treatment of this disease.