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Rhegmatogenous retinal detachments in HIV-positive patients with ocular syphilis
J K Williams1, L S Kirsch, V Russack
1Department of Ophthalmology, University of California at San Diego, La Jolla 92093-0946, USA.
Ophthalmic Surgery and Lasers
|August 1, 1996
Summary
Ocular syphilis can cause retinal detachment in patients with human immunodeficiency virus (HIV). Prompt medical and surgical treatment, including vitrectomy, may preserve vision in these complex cases.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Virology
Background:
- Syphilis (lues) can manifest in the eye, particularly in human immunodeficiency virus (HIV)-positive individuals.
- Retinal manifestations of ocular syphilis in HIV patients can be severe, leading to vision loss.
Observation:
- Two HIV-positive patients presented with bilateral retinitis due to syphilis.
- Following treatment for active retinitis, both patients developed bilateral rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy.
Findings:
- Ocular syphilis was diagnosed clinically and confirmed via cerebrospinal fluid serology.
- Both patients underwent complex surgical repair including pars plana vitrectomy, membrane delamination, and silicone oil instillation for retinal detachment.
Implications:
- Ocular syphilis should be considered in the differential diagnosis of retinal detachment in HIV-positive patients.
- Aggressive and timely surgical intervention is crucial for visual preservation in these cases.