■研究并比较HIV阳性和HIV阴性患者的眼部梅毒的临床特征和转归。
■来自印度一家三级眼科护理医院的回顾性医院病例系列。包括葡萄膜炎和梅毒血清学阳性的患者。人口统计,临床特征,调查,记录了影像学和治疗方式.
■分析了66例患者的一百五只(105只)眼。男性主要受影响（n=57/66，86.4％）。二期梅毒是最常见的表现阶段（n=48/66，72.7％）。确定了两组：HIV阳性（HIVP）患者（n=39/66，59％）和HIV阴性（HIVN）患者（n=27/66，41％）。12/39（30.8％）患者在眼部表现时新诊断为HIV。葡萄膜炎是两组中最常见的表现特征（n=66/105眼，62.8%）。弥漫性坏死性视网膜炎在HIV患者中更为常见（HIVP-15VsHIVN-5眼）。眼部合并感染在HIV患者中更为常见，眼结核,这两个群体中最常见的。静脉注射青霉素和滴定剂量的全身类固醇是治疗的主要手段。注意到平均logMAR从1.415提高到0.828,p值<0.001。在最后的后续行动中，71.8%患者视力改善。95.5%的患者眼部炎症完全缓解。
■考虑到免疫功能低下和免疫功能低下组的各种表现和临床过程，眼部梅毒构成了诊断挑战。临床表现并不总是经典的。具有支持性实验室检查和特征性OCT特征的高怀疑指数有助于诊断。所有葡萄膜炎患者,特别是那些怀疑有传染性病因的人，需要进行梅毒血清学测试，以防止这种复发疾病的视力丧失。
UNASSIGNED: To
study and compare the clinical characteristics and outcome of ocular syphilis between HIV positive and HIV negative patients.
UNASSIGNED: Retrospective hospital-based case series from a tertiary eye care hospital in India. Patients with uveitis and positive syphilis serology were included. Demographics, clinical features, investigations, imaging and treatment modalities were noted.
UNASSIGNED: Hundred and five (105) eyes of 66 patients were analyzed. Males were predominantly affected (n = 57/66, 86.4%). Secondary syphilis was the most common stage of presentation (n = 48/66, 72.7%). Two groups were identified: HIV positive (HIVP) patients (n = 39/66, 59%) and HIV negative (HIVN) patients (n = 27/66, 41%). 12/39 (30.8%) patients were newly diagnosed with HIV at the time of ocular presentation. Panuveitis was the most common presenting feature in both groups (n = 66/105 eyes, 62.8%). Diffuse necrotizing retinitis was more common in HIV patients (HIVP - 15 Vs HIVN - 5 eyes). Ocular co-infections were more common in HIV patients, ocular tuberculosis, the commonest in both groups. Intravenous penicillin and titrated dose of systemic steroids were the mainstay of treatment. Improvement in mean logMAR was noted from 1.415 to 0.828 with p-value < 0.001. At final follow-up, 71.8% patients showed visual improvement. Complete resolution of ocular inflammation was noted in 95.5% patients.
UNASSIGNED: Ocular syphilis poses a diagnostic challenge considering the varied presentations and clinical course both in immunocompromised and immunocompetent groups. Clinical presentations are not always classical. High index of suspicion with supportive laboratory investigations and with characteristic OCT features helps diagnosis. All uveitis patients, especially with those suspected with infectious etiology, need to be tested for syphilis serology to prevent vision loss in this resurgent disease.
