Résumé
ABSTRACT Permanent visual loss can be caused by improper use of immunosuppressive therapy in cases of uveitis without differential diagnosis of syphilitic uveitis. We present four cases of syphilitic uveitis that were incorrectly diagnosed as being secondary to rheumatic diseases and were subsequently treated with immunosuppressive therapy, leading to permanent visual loss. These cases highlight the importance of ruling out syphilis in the differential diagnosis of inflammatory ocular diseases before starting use of immunosuppressive therapy.
RESUMO Elucidar os efeitos adversos do uso de medicações imunossupressoras em pacientes com uveíte não diagnosticada por sífilis. Avaliação de quatro pacientes com uveíte por sífilis submetidos a tratamento com drogas imunossupressoras por suspeita de uveíte secundária a doenças reumáticas, que desenvolveram perda visual permanente. Sífilis deve ser sempre um diagnóstico diferencial nas doenças inflamatórias oculares, principalmente antes do início de terapia imunossupressora.
Sujets)
Femelle , Humains , Mâle , Adulte d'âge moyen , Immunosuppresseurs/effets indésirables , Syphilis/traitement médicamenteux , Uvéite/traitement médicamenteux , Troubles de la vision/étiologie , Diagnostic différentiel , Test FTA-ABS , Immunosuppresseurs/usage thérapeutique , Syphilis/complications , Uvéite/étiologie , Acuité visuelle/effets des médicaments et des substances chimiquesRésumé
Objective To observe the clinical characteristics of patients with macular branch retinal vein occlusion (MBRVO) and the changes of the area of foveal avascular zone (FAZ). Methods The data of 69 eyes of 69 patients with MBRVO , who had been diagnosed by ophthalmoscopy, slit-lamp examination and fluorescein angiography, were retrospectively studied. The relationship of locations between artery and vein on the obstructive site, and the characteristics of fundus pictures, retinal vasculature changes and the complications were analyzed. In 69 patients with MBRVO, 36 had the course of disease for more than 3-6 months, of whom the area of FAZ was compared with that of 30 healthy people. Results In 69 patients, superior MBRVO occurred in 45 eyes (65.22%), and inferior MBRVO occurred in 24 eyes (34.78%). Most of the arteries were anterior to the veins at the obstructive site. Four clinical types of MBRVO were found, and the main complication was macular edema. There was a significant difference in area of FAZ between patients with MBRVO and healthy people (P