1Department of Opthalmology, Beijing You'an Hosptial, Capital Medical University, Beijing 100069, China
2Department of Opthalmology, Tianjin Eye Hospital, Tianjin 300020, China
3Department of Clinical Laboratory, Beijing You'an Hosptial, Capital Medical University, Beijing 100069, China
4Department of Infection Center, Beijing You'an Hosptial, Capital Medical University, Beijing 100069, China
Abstract：Objective: To explore the methods of clinicalfeatureofocular and detection of different samples in laboratory from patients from human immunodefciency virus (HIV) -infected patients with ocular syphilis. Methods: This was a case series study. From January 2022 to September 2022, using random sampling method, 8 patients (11 eyes) with HIV and ocular syphilis who were frst diagnosed in the Ophthalmology Department and Infection Center Department of Beijing You'an Hospital were recruited, and had not received any treatment for syphilis before the visit. All patients have received highly active antiretroviral therapy (HAART). The standard logarithmic visual acuity chart, non-contact tonometer, slit lamp, ultra-wide angle fundus photography and optical cohrence tomography (OCT) were used to observe the best corrected vision, intraocular pressure, anterior segment and fundus of the patient. Blood, cerebrospinal fuid and aqueous humor were extracted by blood extraction, lumbar puncture and paracentesis of anterior chamber. Syphilis infection in the blood, cerebrospinal fluid and aqueous humor of the patients were detected by rapid plasma regain (RPR) and Treponema pallidum particle agglutination (TPPA). According to the treatment principle of neurosyphilis, 8 cases of ocular syphilis were treated with penicillin by intravenous drip. Follow up for 3-6 months. Results: All 8 patients were HIV-infected, including 6 males and 2 females. Ten eyes of 11 patients were syphilitic optic neuroretinitis, and 1 eyes were syphilis-related anterior uveitis. The number of CD4+T lymphocytes count in peripheral blood of patients was average 147 (67, 318) cell/μL. The HIV viral load was average 1 295 (0, 4 801) copies/mL. Eight patients showed positive TPPAand RPR in blood, TPPAin cerebrospinal fuids were positive in 8 cases, and RPR in cerebrospinal fuids were positive in 7 cases. The TPPA in aqueous humor of 11 eyes were positive, and the RPR in aqueous humor of 10 eyes were positive. After regular treatment of penicillin, the best corrected vision of 8 patients were signifcantly improved. Conclusions: The detection of TPPAand RPR in blood, cerebrospinal fuid and aqueous humor are important laboratory test methods for the diagnosis of HIV infected patients with ocular syphilis. The detection of TPPAand RPR in aqueous humor is helpful for the diagnosis of HIV infected patients with ocular syphilis who are frst diagnosed in ophthalmology.
孔文君, 谢连永, 杜葵芳, 等. HIV感染者合并眼梅毒的眼部特点及实验室标本检测[J]. 中华眼视光学与视觉科学杂志, 2023, 25(7): 492-498.
Wenjun Kong1, Lianyong Xie1, Kuifang Du1, et al. ClinicalFeatureofOcular and Detection of Different Laboratory Samples from HIV Infector with Ocular Syphilis . Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(7): 492-498. DOI: 10.3760/cma.j.cn115909-20230210-00029
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