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目的:报告1例罕见的由梅毒感染引起的视神经周围炎,经皮质类固醇治疗后严重视力缺损得到显著改善。方法:病例报告。结果:一名66岁马来裔女性患者来我院就诊,一眼突然出现视力缺损,动眼时有疼痛感。视力无光感,右眼出现相对性瞳孔传入缺陷(relative afferent pupillary defect,RAPD)。血清学和放射学检查证明为梅毒性视神经周围炎。肌肉注射苄星青霉素,静脉注射甲基醋酸泼尼松龙,然后长期口服类固醇,剂量逐渐降低。经过治疗,患者视力明显提高,恢复到6/18。随访4mo,未出现复发和类固醇相关的副作用。结论:本病诊断正确、治疗及时,能使患者视力得到显著改善。
OBJECTIVE: To report a rare case of peripheral optic neuritis caused by syphilis infection, with significant improvement of visual impairment after corticosteroid treatment. Methods: Case report. Results: A 66-year-old Malaysian woman came to our hospital for medical treatment. No light perception, relative right pupillary defect (RAPD) in the right eye. Serological and radiological evidence of peritoneal inflammation of the optic nerve. Intramuscular injection of benzathine penicillin, intravenous injection of prednisolone methyl acetate, and then long-term oral steroids, the dose decreased. After treatment, patients significantly improved visual acuity, restored to 6/18. Follow-up 4mo, recurrence and steroid-related side effects did not occur. Conclusion: The diagnosis of this disease is correct, timely treatment, patients can significantly improve visual acuity.