Ocular manifestations of syphilitic uveitis in Chinese patients

To present the manifestations of syphilitic uveitis in Chinese patients.

This is a retrospective case series of 35 eyes of 19 patients with syphilitic uveitis. The data of these patients including complaints, ocular and systemic manifestations, human immunodeficiency virus status, results of auxiliary examinations, treatment, and follow-up were reviewed.

Nineteen consecutive Chinese patients were diagnosed with syphilitic uveitis by serologic tests. Four patients had circulating human immunodeficiency virus antibodies. Ocular involvement was found in 35 eyes. Posterior segment involvement was found in 30 eyes of 17 patients (85.7%), whereas anterior segment involvement was found in 14 eyes of 8 patients (40.0%). Thirty eyes of 17 patients (85.7%) presented with vitreous opacities and 28 eyes of 16 patients (80.0%) with retinitis. Papillitis and retinal vasculitis were found in 10 eyes of 6 patients (28.6%) and 7 eyes of 4 patients (20.0%), respectively. Multiple precipitates on the retina and posterior vitreous membrane were observed in six eyes of three patients. A large iris granuloma was observed in one eye.

Posterior uveitis was the most common ocular finding in these investigated Chinese patients with syphilis. Coinfection of syphilis and human immunodeficiency virus was less common in these patients. Syphilis should be considered in the differential diagnosis of patients presenting with large iris granulomas.