April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Clinical Features and Incidence Rate of Ocular Complications in Patients with Ocular Syphilis in the Absence of HIV infection.
Author Affiliations & Notes
  • Ahmadreza Moradi
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • Sherveen Salek
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • Ebenezer Daniel
    Scheie Eye Institute, The University of Pennsylvania, Philadelphia, PA
    Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, The University of Pennsylvania, Philadelphia, PA
  • Sapna Gangaputra
    Ophthalmology, University of Wisconsin, Madison, WI
  • Trucian A Ostheimer
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • Bryn Burkholder
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • Theresa G Leung
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • Nicholas J Butler
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • James P Dunn
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
  • Jennifer E Thorne
    Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD
    Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5294. doi:
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      Ahmadreza Moradi, Sherveen Salek, Ebenezer Daniel, Sapna Gangaputra, Trucian A Ostheimer, Bryn Burkholder, Theresa G Leung, Nicholas J Butler, James P Dunn, Jennifer E Thorne; Clinical Features and Incidence Rate of Ocular Complications in Patients with Ocular Syphilis in the Absence of HIV infection.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5294.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To describe the incidence rates (IR), treatment, and clinical features of ophthalmic manifestations of ocular syphilis in the absence of human immunodeficiency virus (HIV) infection in a tertiary ophthalmology referral clinic.

 
Methods
 

Retrospective, consecutive chart review was performed on patients with ocular syphilis in the absence of HIV infection among patients attending the ocular immunology clinics at Johns Hopkins Hospital between 1984 and 2013. Demographic and clinical characteristics were noted at the time of presentation. Outcomes were determined retrospectively. Main outcome measures were the IR of vision impairment (20/50 or worse), loss of visual acuity (20/200 and worse), and development of ocular complications.

 
Results
 

15 patients (25 eyes) were included in the study. Follow-up data were available for 13 patients (21 eyes) with a mean follow-up time of 18.9 months (range 0.6-52.9). The incidence rates of visual impairment and visual loss were 0.29 per eye-year (EY) (95% CI: 0.06 -0.86) and 0.07/EY (95% CI: 0.009 - 0.27), respectively. 11 eyes had an ultimate visual acuity of 20/40 or better (52%). The incidence rate of new ocular hypertension (IOP>21mmHg) was 0.20/EY (95% CI: 0.07 -0.43). None of the eyes had epiretinal membrane (ERM) at presentation; however, 6/21 of them developed ERM during the follow-up (IR: 0.21, 95% CI: 0.07 - 0.45). No new retinal detachment, hypotony, choroidal neovascularizaiton, or optic neuropathy was observed during follow-up of the patients.

 
Conclusions
 

The re-emergence of syphilis has raised the importance of better characterizing its ocular manifestations. Tertiary syphilis has a broad range of ocular manifestations, the differential for which remains broad and requires proper diagnostic workup. Our data collected over three decades demonstrates the importance of proper treatment in the responsiveness and recovery of visual acuity with intravenous penicillin, and close monitoring in the subsequent months.

 
Keywords: 746 uveitis-clinical/animal model • 745 uvea • 557 inflammation  
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