Clinical features and incidence rates of ocular complications in patients with ocular syphilis.
Publication/Presentation Date
2-1-2015
Abstract
PURPOSE: To describe the clinical outcomes of ocular syphilis.
DESIGN: Retrospective chart review.
METHODS: The charts of patients with ocular syphilis (regardless of human immunodeficiency virus [HIV] status) seen in a uveitis referral center between 1984 and 2014 were reviewed.
RESULTS: The study included 35 patients (61 eyes). Panuveitis was the most common type of ocular inflammation (28 eyes), independent of HIV status. Thirty-three of 35 patients received systemic antibiotics with 24 patients treated with intravenous (IV) penicillin only. When compared to the HIV-positive patients, HIV-negative patients with ocular syphilis were older (P < .001), were more likely to be female (P = .004), and had poorer visual acuity at presentation (P = .01). During follow-up, the incidence rates of visual impairment were 0.29 per eye-year (EY; 95% confidence interval [CI]: 0.06/EY-0.86/EY) and 0.12/EY (95% CI: 0.01/EY-0.42/EY) among the HIV-negative and the HIV-positive patients, respectively. The incidence of blindness was 0.07/EY (95% CI: 0.009/EY-0.27/EY) and 0.06/EY (95% CI: 0.002/EY-0.35/EY) among the HIV-negative and the HIV-positive patients, respectively. Longer duration of uveitis prior to diagnosis and chorioretinitis in the macula at presentation were associated with ≥ 2 Snellen lines of visual loss (P < .01) and visual acuity loss to 20/50 or worse (P = .03) in HIV-negative patients, respectively.
CONCLUSIONS: Syphilis is an uncommon cause of ocular inflammation in both HIV-negative and HIV-positive patients. Visual loss and ocular complications were common among HIV-negative patients even with systemic antibiotic treatment. Delay of diagnosis and chorioretinitis in the macula were associated with visual loss in these patients.
Volume
159
Issue
2
First Page
334
Last Page
343
ISSN
1879-1891
Published In/Presented At
Moradi, A., Salek, S., Daniel, E., Gangaputra, S., Ostheimer, T. A., Burkholder, B. M., Leung, T. G., Butler, N. J., Dunn, J. P., & Thorne, J. E. (2015). Clinical features and incidence rates of ocular complications in patients with ocular syphilis. American journal of ophthalmology, 159(2), 334–43.e1. https://doi.org/10.1016/j.ajo.2014.10.030
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
25447116
Department(s)
Administration and Leadership
Document Type
Article