眼部梅毒并发双侧视神经病变。

IF 0.8 Q4 CLINICAL NEUROLOGY Neuro-Ophthalmology Pub Date : 2023-07-05 eCollection Date: 2023-01-01 DOI:10.1080/01658107.2023.2222800
Mustafa Kayabaşı, Seher Köksaldı, Ali Osman Saatci, Meltem Söylev Bajin
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引用次数: 0

摘要

一名 60 岁、身体健康的男性患者出现双侧进行性视力下降,病史已有 1 年。他的最佳矫正视力为右眼在 2 米处数手指,左眼在 0.5 米处数手指。视野测试显示双侧视野接近完全丧失。裂隙灯检查除了双侧二级核硬化性白内障外,没有其他异常。双侧视盘外观苍白,左侧乳头状区有一些视网膜色素上皮改变。增强深度成像光学相干断层扫描显示,左眼视网膜色素上皮病变对应的脉络膜内层有点状高反射点。眼底自发荧光成像显示斑片状高自发荧光区和低自发荧光区,左眼乳头黄斑区荧光素血管造影早期和晚期有轻度染色。诊断结果为双侧视神经病变。对他进行了全面的全身检查,血清学检测显示存在梅毒,头颅磁共振成像正常。他接受了相应的治疗。我们的病例清楚地表明,临床上高度怀疑梅毒对视神经病变的重要性。
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Presentation of Ocular Syphilis with Bilateral Optic Neuropathy.

A 60-year-old otherwise healthy male presented with a 1 year history of bilateral progressive visual loss. His best-corrected visual acuity was counting fingers at 2 m with his right eye and counting fingers at 0.5 m with his left eye. Visual field testing revealed bilateral near-total loss of visual fields. Slit-lamp examination was unremarkable, apart from bilateral grade two nuclear sclerotic cataracts. Both optic discs were pale-looking with some retinal pigment epithelial alterations at the left papillomacular region. Enhanced depth imaging optical coherence tomography depicted punctate hyperreflective dots at the inner choroidal level corresponding to the retinal pigment epithelial changes in the left eye. Fundus autofluorescence imaging revealed patchy hyper-autofluorescent and hypo-autofluorescent areas, and there was mild staining in the early and late phases of the fluorescein angiogram at the papillomacular region in the left eye. A diagnosis of bilateral optic neuropathy was made. A full systemic work-up was carried out, and serological tests pointed out the presence of syphilis with normal cranial magnetic resonance imaging. He was treated accordingly. Our case clearly demonstrates the importance of a high clinical suspicion for syphilis in cases of optic neuropathy.

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来源期刊
Neuro-Ophthalmology
Neuro-Ophthalmology 医学-临床神经学
CiteScore
1.80
自引率
0.00%
发文量
51
审稿时长
>12 weeks
期刊介绍: Neuro-Ophthalmology publishes original papers on diagnostic methods in neuro-ophthalmology such as perimetry, neuro-imaging and electro-physiology; on the visual system such as the retina, ocular motor system and the  pupil; on neuro-ophthalmic aspects of the orbit; and on related fields such as migraine and ocular manifestations of neurological diseases.
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