Increase in Ocular Syphilis Cases at Ophthalmologic Reference Center, France, 2012-2015

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• Ocular syphilis is a re-emerging infectious disease with diverse clinical presentations.
• Syphilis, caused by *Treponema pallidum*, can affect various parts of the eye.
• Understanding trends and outcomes is crucial for timely diagnosis and management.

Purpose of the Study:

• To determine the frequency, demographics, clinical features, and visual outcomes of ocular syphilis.
• To analyze trends in ocular syphilis incidence between 2012 and 2015.
• To investigate the impact of Human Immunodeficiency Virus (HIV) co-infection on visual prognosis.

Main Methods:

• Retrospective case series analysis of ocular syphilis patients.
• Data collected from a tertiary reference center in Paris, France (2012-2015).
• Evaluation of demographic data, clinical findings, HIV co-infection status, and visual acuity outcomes.

Main Results:

• Twenty-one cases (29 eyes) of ocular syphilis were identified, with a rising incidence from 2012 to 2015.
• The majority (76%) of cases occurred in men who have sex with men; 20-33% were co-infected with HIV annually.
• Seventy-five percent achieved good final visual acuity, but HIV-positive patients had worse outcomes (p=0.0139).
• Optimal visual outcomes were associated with prompt consultation (mean 15 days from symptom onset).

Conclusions:

• Ocular syphilis incidence increased significantly during the study period.
• Prompt diagnosis and treatment, particularly in at-risk populations, are vital for preserving vision.
• HIV co-infection presents a significant challenge, leading to poorer visual prognoses in ocular syphilis patients.