SUPERFICIAL RETINAL PRECIPITATES IN PATIENTS WITH SYPHILITIC RETINITIS
SUPERFICIAL RETINAL PRECIPITATES IN PATIENTS WITH SYPHILITIC RETINITIS
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DOI：
10.1097/iae.0b013e3181cdf3ae
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发表时间：
2010-07-01
影响因子：
3.3
通讯作者：
Cunningham, Emmett T., Jr.
中科院分区：
文献类型：
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作者：
Fu, Evelyn X.;Geraets, Ryan L.;Cunningham, Emmett T., Jr.
目的：本研究的目的是描述梅毒性视网膜炎患者中浅表视网膜沉淀物的发生情况。方法：这是一项回顾性、观察性病例系列，研究对象为 8 名伴有浅表视网膜沉淀物的梅毒性视网膜炎患者的 9 只眼睛。审查了临床、摄影、血管造影和实验室记录。观察这些浅表视网膜沉淀物的特征和治疗反应。结果：所有患者均为白人男性，其中男男性行为者5例（62.5%），人类免疫缺陷病毒阳性6例（75.0%）。这些患者之前都没有被诊断出患有梅毒。所有患者均出现全葡萄膜炎和明显透明或毛玻璃状视网膜炎，并伴有乳黄色浅层视网膜沉淀物。 3 名患者（37.5%）的视网膜炎具有独特的楔形外观。 5 名患者（62.5%）患有相关性视网膜血管炎，3 名患者（37.5%）患有浆液性视网膜脱离，2 名患者（22.2%）患有视网膜内出血，2 名患者（22.2%）患有乳头炎。在开始静脉青霉素治疗后 2 周内，7 名患者 (87.5%) 的视力恢复至≥ 20/40。完成抗生素治疗后，所有受影响的眼睛均表现出临床症状快速消退，先前视网膜炎区域的视网膜色素上皮细胞变化最小。结论：梅毒性视网膜炎区域可能会出现特征性浅表视网膜沉淀。提高对这种高度提示性临床症状的认识可能有助于早期诊断和治疗。视网膜 30:1135-1143, 2010
Purpose: The purpose of this study was to describe the occurrence of superficial retinal precipitates in patients with syphilitic retinitis.Methods: This was a retrospective, observational case series of nine eyes of eight patients with syphilitic retinitis associated with superficial retinal precipitates. The clinical, photographic, angiographic, and laboratory records were reviewed. Characteristics and treatment response of these superficial retinal precipitates were observed.Results: All patients were Caucasian men, including 5 men who have sex with men (62.5%) and 6 (75.0%) who were positive for human immunodeficiency virus. None of the patients were previously diagnosed with syphilis. All patients developed panuveitis and a distinctly diaphanous or ground-glass retinitis associated with creamy yellow superficial retinal precipitates. In 3 patients (37.5%), the retinitis had a distinctive wedge-shaped appearance. Five patients (62.5%) had associated retinal vasculitis, 3 (37.5%) had serous retinal detachment, 2 (22.2%) had intraretinal hemorrhage, and 2 (22.2%) had papillitis. Within 2 weeks of initiating intravenous penicillin treatment, 7 patients (87.5%) experienced visual recovery to >= 20/40. All affected eyes showed rapid resolution of clinical signs with minimal alternations of the retinal pigment epithelium in areas of prior retinitis after completion of antibiotic therapy.Conclusion: Characteristic superficial retinal precipitates may occur over areas of syphilitic retinitis. Improved recognition of this highly suggestive clinical sign may aid in early diagnosis and treatment. RETINA 30:1135-1143, 2010