梅毒性視神経網脈絡膜炎の2例

Two cases of syphilitic neuroretinochoroiditis

　28歳の男子の両眼と21歳男子の片眼に視力障害が突発した。梅毒の全身症状を欠いていたが，梅毒血清抗体価が高値を示したため，梅毒性視神経網脈絡膜炎と診断した。駆梅療法としての抗生物質投与と副腎皮質ステロイド薬の内服によく反応し，予後は良好であった。原因不明のぶどう膜炎，視神経炎などを見た場合，鑑別診断のひとつに梅毒を念頭に置く必要がある。

We diagnosed two males, aged 21 and 28 years, as acute syphilitic neuroretinochoroiditis. The condi-tion was unilateral in one and bilateral in the other. Both cases were initially diagnosed as optic papil-litis but failed to respond to the systemic corticos-teroid therapy. Syphilitic nature of the lesion was confirmed after positive serological tests. Treat-ment with systemic antibiotics and corticosteroid led to prompt resolution of the lesion and to improvement in vision. Syphilis may serve as the causative factor in uveitis and optic neuritis of unknown origin.