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Syphilitic uveitis and optic neuritis in Sydney, Australia
Luke C Northey1, Simon E Skalicky1, Avinash Gurbaxani1
1Save Sight Institute, Discipline of Ophthalmology, Sydney Eye Hospital Campus, The University of Sydney, Sydney, Australia.
The British Journal of Ophthalmology
|March 20, 2015
Summary
Ocular syphilis presents with diverse symptoms affecting both the front and back of the eye. High rates of human immunodeficiency virus (HIV) coinfection were observed, with vision improving after treatment.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Syphilis is a systemic infection with potential ocular manifestations.
- Ocular syphilis can present with a wide range of clinical findings.
- Human immunodeficiency virus (HIV) coinfection is a significant concern in patients with syphilis.
Purpose of the Study:
- To characterize the clinical presentations of ocular syphilis.
- To determine the frequency of HIV coinfection in patients with ocular syphilis.
- To evaluate visual outcomes following treatment for ocular syphilis.
Main Methods:
- Retrospective chart review of ocular syphilis cases at a tertiary referral eye hospital.
- Inclusion criteria: positive syphilis serology, ocular inflammation, and appropriate treatment.
- Outcome measures: clinical features and best-corrected visual acuity (BCVA).
Main Results:
- Thirty-seven eyes of 25 patients were analyzed.
- Predominantly male patients (92.0%) with a mean age of 43.7 years.
- High HIV coinfection rate (32.0%), with some newly diagnosed.
- Anterior segment involvement (32.4%) and posterior segment involvement (67.6%) were common.
- Significant improvement in BCVA at 1 and 2-3 months post-treatment.
Conclusions:
- Ocular syphilis exhibits a broad spectrum of clinical manifestations.
- High rates of HIV coinfection necessitate screening and management.
- Prompt syphilis treatment leads to improved visual outcomes.
