Abstract：
UNASSIGNED: Uveitis is the most common ocular manifestation of syphilis. However, an association between syphilitic uveitis and rhegmatogenous retinal detachment (RRD) is not widely recognized. We report a consecutive series of six new cases of syphilitic uveitis complicated by RRD and describe the typical characteristics, clinical course, and surgical management of such cases.
UNASSIGNED: Consecutive case series and comprehensive review of the literature.
UNASSIGNED: We identified a total of 19 cases (23 eyes) with syphilitic uveitis subsequently complicated by RRD, including six new cases (seven eyes) reported here and 13 cases (16 eyes) previously reported in the literature. Fifteen patients (79%) were positive for human immunodeficiency virus (HIV) and not on combination antiretroviral therapy. Most retinal detachments developed within two months of uveitis presentation; retinal breaks were often found in areas of previous retinitis. Sixteen eyes (70%) were complicated by early proliferative vitreoretinopathy. Twenty-one eyes underwent surgical repair, of which six (26%) suffered re-detachment. Surgical management commonly involved pars-plana vitrectomy and silicone oil tamponade, with or without scleral buckling. Visual outcomes were generally poor: only six eyes (26%) attained visual acuity of 20/40 or better and 11 eyes (48%) remained 20/200 or worse.
UNASSIGNED: Patients with syphilitic uveitis, as with viral retinitis, should be monitored closely for the development of retinal tears and RRD. A combination of pars plana vitrectomy with silicone oil tamponade and/or scleral buckle placement is a prudent surgical approach to most cases of syphilitic RRD, although visual prognosis remains guarded.
UNASSIGNED: Consecutive case series and comprehensive review of the literature.
UNASSIGNED: We identified a total of 19 cases (23 eyes) with syphilitic uveitis subsequently complicated by RRD, including six new cases (seven eyes) reported here and 13 cases (16 eyes) previously reported in the literature. Fifteen patients (79%) were positive for human immunodeficiency virus (HIV) and not on combination antiretroviral therapy. Most retinal detachments developed within two months of uveitis presentation; retinal breaks were often found in areas of previous retinitis. Sixteen eyes (70%) were complicated by early proliferative vitreoretinopathy. Twenty-one eyes underwent surgical repair, of which six (26%) suffered re-detachment. Surgical management commonly involved pars-plana vitrectomy and silicone oil tamponade, with or without scleral buckling. Visual outcomes were generally poor: only six eyes (26%) attained visual acuity of 20/40 or better and 11 eyes (48%) remained 20/200 or worse.
UNASSIGNED: Patients with syphilitic uveitis, as with viral retinitis, should be monitored closely for the development of retinal tears and RRD. A combination of pars plana vitrectomy with silicone oil tamponade and/or scleral buckle placement is a prudent surgical approach to most cases of syphilitic RRD, although visual prognosis remains guarded.
摘要：
■葡萄膜炎是梅毒最常见的眼部表现。然而,梅毒性葡萄膜炎和孔源性视网膜脱离(RRD)之间的关联尚未得到广泛认可.我们报告了一系列连续6例新的梅毒性葡萄膜炎并发RRD的病例，并描述了典型特征，临床课程，以及此类病例的外科治疗。
■连续案例系列和全面的文献综述。
■我们发现19例（23只眼）梅毒性葡萄膜炎随后并发RRD，包括此处报告的6例新病例（7只眼）和文献中先前报告的13例（16只眼）。15例患者（79％）对人类免疫缺陷病毒（HIV）呈阳性，未接受联合抗逆转录病毒治疗。大多数视网膜脱离在葡萄膜炎出现的两个月内发生；视网膜破裂通常在以前的视网膜炎区域发现。16眼（70％）并发早期增生性玻璃体视网膜病变。21只眼睛接受了手术修复，其中六人(26%)遭受重新脱离。手术治疗通常包括平坦部玻璃体切除术和硅油填塞，有或没有巩膜扣带。视力结果通常较差：只有6只眼睛（26％）达到20/40或更好的视力，11只眼睛（48％）保持20/200或更差。
■梅毒性葡萄膜炎患者，与病毒性视网膜炎一样，应密切监测视网膜撕裂和RRD的发展。对于大多数梅毒性RRD病例，将平坦部玻璃体切除术与硅油填塞和/或巩膜扣放置相结合是一种谨慎的手术方法。尽管视觉预后仍然受到保护。
■连续案例系列和全面的文献综述。
■我们发现19例（23只眼）梅毒性葡萄膜炎随后并发RRD，包括此处报告的6例新病例（7只眼）和文献中先前报告的13例（16只眼）。15例患者（79％）对人类免疫缺陷病毒（HIV）呈阳性，未接受联合抗逆转录病毒治疗。大多数视网膜脱离在葡萄膜炎出现的两个月内发生；视网膜破裂通常在以前的视网膜炎区域发现。16眼（70％）并发早期增生性玻璃体视网膜病变。21只眼睛接受了手术修复，其中六人(26%)遭受重新脱离。手术治疗通常包括平坦部玻璃体切除术和硅油填塞，有或没有巩膜扣带。视力结果通常较差：只有6只眼睛（26％）达到20/40或更好的视力，11只眼睛（48％）保持20/200或更差。
■梅毒性葡萄膜炎患者，与病毒性视网膜炎一样，应密切监测视网膜撕裂和RRD的发展。对于大多数梅毒性RRD病例，将平坦部玻璃体切除术与硅油填塞和/或巩膜扣放置相结合是一种谨慎的手术方法。尽管视觉预后仍然受到保护。
