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Ocular syphilis

Zsuzsanna Géhl1, Béla Tamási2, András Bánvölgyi2

  • 11 Általános Orvostudományi Kar, Szemészeti Klinika, Semmelweis Egyetem, Budapest, Üllői út 26., 1085.

Orvosi Hetilap
|November 8, 2020
PubMed
Summary
This summary is machine-generated.

Syphilis-related uveitis, predominantly affecting middle-aged men, often involves the posterior segment. Prompt penicillin treatment leads to resolution of inflammation and good visual outcomes in most patients, though optic nerve atrophy can impair vision.

Keywords:
chorioretinitisneurosyphilissyphilisuveitis

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Public Health

Background:

  • Syphilis is a systemic infection that can manifest with ocular complications, including uveitis.
  • Uveitis, an inflammation of the uvea, can lead to significant vision loss if not diagnosed and treated promptly.
  • Identifying syphilis as the underlying cause of uveitis is crucial for effective treatment and management.

Purpose of the Study:

  • To detail the ocular and systemic signs of syphilis-induced uveitis.
  • To analyze the prognosis of uveitis cases where syphilis was diagnosed during the workup.
  • To evaluate the effectiveness of penicillin treatment for syphilitic uveitis.

Main Methods:

  • Retrospective analysis of 14 uveitis patients diagnosed with syphilis between 2011 and 2019.
  • Inclusion criteria: patients with uveitis where syphilis was identified during the diagnostic process.
  • Data collected included ocular manifestations, visual acuity, treatment, and follow-up outcomes.

Main Results:

  • The study included 14 patients (13 males, 1 female) with symptoms in 25 eyes; mean age was 46 years.
  • Posterior uveitis was the most common manifestation (20 eyes), presenting as papillitis, chorioretinitis, or combined forms.
  • Following penicillin treatment, inflammatory symptoms resolved in all patients, with most achieving complete visual recovery; improved visual acuity from mean 0.71/0.53 to 0.9/0.82 (right/left eye).

Conclusions:

  • Syphilitic uveitis predominantly affects middle-aged men and often involves the posterior segment of the eye.
  • Despite posterior segment involvement, appropriate penicillin therapy results in a good prognosis and visual recovery.
  • Optic nerve atrophy and macular damage were identified as causes of persistent visual impairment in some cases.