梅毒性脉络膜视网膜炎的诊断和治疗

Diagnosis and Treatment of Syphilitic Choroidal Retinitis

目的探讨一组脉络膜视网膜病变患者的诊断及治疗经验。方法收集3例典型的梅毒性脉络膜视网膜炎患者和1例急性后极部多灶性鳞状色素上皮病变(APMPPE)患者及1例匐行性脉络膜病变患者资料。对比患者病史、全身及专科检查,完善最佳矫正视力(BCVA)、裂隙灯、双目间接眼底镜、眼底照相、自发荧光(AF)、眼底荧光血管造影(FFA)、黄斑光学相干断层成像(OCT)等辅助检查,及血常规、血沉、超敏C反应蛋白、输血全套等实验室检查结果。探讨和总结梅毒性脉络膜视网膜炎患者临床表现及诊断和治疗经验。结果有3例患者经实验室检查诊断为梅毒性脉络膜视网膜炎,对症治疗后视力均明显提高。结论梅毒性脉络膜视网膜炎眼底表现复杂,需仔细追问病史、完善全身及各项专科及辅助检查,早期明确诊断并及时对症治疗后,预后较好。

Objective To evaluate the diagnosis and treatment experience of a group of patients with syphilitic choroidal retinitis.Methods The data of 3 patients with typical syphilitic chorioretinitis,1 patient with acute posterior polar multifocal squamous pigment epithelial lesion(APMPPE)and 1 patient with serpiginous chorioidopathy were collected.Patients'medical history,systemic and specialized examinations were compared,and auxiliary examinations such as best corrected visual acuity(BCVA),slit lamp,binocular indirect fundus lens,fundus photography,autofluorescence(AF),FFA,macular OCT,and blood routine examination results,ESR,hypersensitive C-reactive protein,and blood transfusion sets were improved.The clinical manifestations,diagnosis and treatment experience of syphilitic chorioretinitis were explored and summarized.Results Three patients were diagnosed with syphilitic chorioretinitis by laboratory examination,and their visual acuity was improved significantly after corresponding treatment.Conclusion The fundus manifestations of syphilitic chorioretinitis are complex,and the prognosis is good only after careful investigation of the history,improvement of the whole body and various specialties and auxiliary examinations,early diagnosis and timely symptomatic treatment.