摘要目的 回顾8例首诊于眼科的梅毒性后葡萄膜炎患者的诊治经过,为今后葡萄膜炎的正确诊治提供参考.方法 回顾性分析2011年6月至2013年6月临床及血清学确诊的梅毒性葡萄膜炎患者8例16只眼的临床资料.其中男性6例,女性2例;年龄35～49岁,平均40岁.所有患眼均进行矫正视力、眼压、裂隙灯显微镜检查及眼底彩色照相;FFA检查14只眼.驱梅治疗后随访3～9个月,中位数6个月.结果 16只患眼均表现为后葡萄膜炎.眼底照相主要表现为:视盘充血水肿9只眼;后极部视网膜水肿14只眼;后极部及中周部视网膜下黄白色渗出灶11只眼;玻璃体腔出血2只眼.FFA检查主要表现为:视盘毛细血管扩张,荧光渗漏10只眼;视网膜血管壁荧光渗漏9只眼;视网膜动脉和(或)静脉阶段性闭塞,无荧光充盈5只眼;黄斑区毛细血管荧光渗漏,晚期囊样染料积存7只眼;后极部视网膜早期斑片状弱荧光,晚期荧光染色14只眼.结论 梅毒性后葡萄膜炎是葡萄膜炎的一种特殊类型,可不伴眼外表现,临床易误诊与漏诊.故对于不明原因的葡萄膜炎患者,推荐常规检测PRP及TPHA,以提高基层医院的诊断准确率.

abstractsObjective To review the diagnosis process of the patients with syphilitic uveitis.Methods Eight syphilitic uveitis patients were retrospectively analyzed.The diagnoses were confirmed by clinical and laboratory tests.There were 8 patients (16 eyes),6 males and 2 females.The ages were from 35 to 49,with a mean age of 40 years old.All patients had examinations including visual acuity,intraocular pressure,slit-lamp biomicroscopy and ophthalmoscopy.Fundus fluorescein angiography (FFA) was carried on 7 patients (14 eyes).Results All patients were confirmed to be posterior uveitis.Nine eyes showed congestion and swelling of optic discs,swelling of retina in 14 eyes,yellow-white lesions in the posterior pole in 11 eyes.FFA showed staining or hyperfluorescence of optic disc in 10 eyes,venous leakage in 9 eyes,and cystoid macular edema in 7 eyes.Conclusions Syphilitic posterior uveitis is a specific type of uveitis which can be without extraocular manifestation.Testing PRP and TPHA is important for improving diagnosis.