RHEGMATOGENOUS RETINAL DETACHMENTS IN HIV-POSITIVE PATIENTS WITH OCULAR SYPHILIS

The purpose of this study is to report retinal manifestations of lues in human immunodeficiency virus (HIV)-positive patients and to suggest a method for treatment of rhegmatogenous retinal detachments in these patients. Two HIV-positive patients with bilateral retinitis were exa mined and treated at the authors' institution for a period of 14 month s. Ocular syphilis was diagnosed clinically, confirmed by cerebrospina l fluid serologic testing, and treated with intravenous penicillin. Bo th patients experienced bilateral rhegmatogenous retinal detachments c omplicated by proliferative vitreoretinopathy after resolution of the active retinitis. All four eyes underwent surgical repair with trans p ars plana vitrectomy, epiretinal membrane delamination, gas-fluid exch ange, endolaser, scleral buckle, and silicone oil instillation. The re cognition of ocular syphilis as a cause of retinal detachment in HIV-p ositive patients is important. Prompt intervention with the appropriat e medical and surgical treatments may result in the preservation of vi sion in these patients.