Unilateral Macular Hypopyon and Bilateral Optic Perineuritis from Secondary Syphilis-Case Report

次級梅毒造成之黃斑部膿瘍及視神經束衣炎

曾莉芳(Li-Fang Tseng) ； 黃峻峰(Jiunn-Feng Hwang) ； 陳珊霓(San-Ni Chen)

《中華民國眼科醫學會雜誌》 47卷3期 (2008/09) Pp. 224-227

https://doi.org/10.30048/ACTASOS.200809.0004

摘要

目的：報告一例梅毒造成之黃斑部膿瘍及視神經束衣炎。
方法：病例報告。
結果：51歲男性，出現左眼持續性視力模糊已有兩個月，檢查後發現雙眼視神經盤水腫及左眼黃斑部膿瘍，經梅毒血清檢驗證實為梅毒患者。於每週肌肉內注射盤尼西林(Penicillin G Benzathine)三個療程後，其眼部病灶幾乎完全消失且視力恢復正常。
結論：由梅毒引發之視神經盤水腫對視力可能不會造成影響，但其可能伴隨黃斑部膿瘍因此造成患者視力模糊前來就醫。早期發現與治療可以幫助患者恢復視力並減少梅毒產生的其他後遺症，因此眼科醫師在此扮演非常重要的角色。

並列摘要

Purpose: To report a case of secondary syphilis with unilateral macular hypopyon and bilateral optic perineuritis.
Method: A case report.
Result: A 51-year-old man experienced progressively blurred vision in his left eye for 2 months. Fundoscopy revealed disc edema in both eyes and macular hypopyon in the left eye. On fluorescein angiography, there was perivascular leakage at the posterior pole in the left eye and optical coherence tomography showed subretinal fluid. Positive serologic testing for syphilis was noted. Intramuscular Penicillin G Benzathine was administered once every week for three courses. There was near total resolution of macular hypopyon after treatment.
Conclusion: Secondary syphilis may present with macular hypopyon and induced blurred vision. Optic perineuritis in secondary syphilis may not affect vision. Early awareness of macular hypopyon and perineuritis from secondary syphilis allows rapid diagnosis and therapy.

並列關鍵字

Secondary syphilis ； macular hypopyon ； optic perineuritis