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Wydanie 2/2010
str. 113

Zanik nerwu wzrokowego w przebiegu kiły ośrodkowego układu nerwowego – patofizjologia, symptomatologia, diagnostyka i leczenie na podstawie własnych przypadków klinicznych

Optic Nerve Atrophy Associated with Central Nervous System Syphilis

Barbara Terelak-Borys, Jacek Kosmala, Anna Christman, Beata Janiszewska, Michał Kamiński, Iwona Grabska-Liberek

Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Kierownik: dr hab. n. med. Iwona Grabska-Liberek

Summary: The aim of this article is to present four different pictures of syphilitic optic nerve atrophy in adults: the first one - typical optic nerve atrophy, the second – optic nerve atrophy coexisting with high myopia, the third - optic nerve atrophy coexisting with tumescent cataract and increased intraocular pressure without glaucomatous excavation, and the fourth – optic nerve atrophy with clinical features of normal tension glaucoma. Also in the second case (optic nerve atrophy in high myopia) glaucomatous-like excavation of the optic nerve head without elevated intraocular pressure led to the diagnosis of normal-tension glaucoma at first. In all four cases, optic nerve atrophy was the only symptom of central nervous system infection in the course of syphilis. Disease diagnosis was confirmed by positive blood and cerebrospinal fluid serological tests. We stress that syphilis should be considered as a possible cause of especially bilateral optic nerve atrophy even nowadays.

Słowa kluczowe: kiła ośrodkowego układu nerwowego, zanik nerwu wzrokowego, jaskra.

Keywords: central nervous system syphilis, optic nerve atrophy, glaucoma.

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