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Rosalva Yasha Bobadilla, Ricardo Blas Medina, Daniela Castro Farias, Elsa Maria Flores Reyes, Miguel Pedroza-Seres; Clinical features of syphilitic uveitis in an ophthalmologic reference center in Mexico City. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5763.
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© ARVO (1962-2015); The Authors (2016-present)
To describe demographic data of patients with diagnosis of ocular syphilis in the department of uveitis and ocular immunology at Hospital Conde de Valenciana, an ophthalmologic reference center in Mexico
we analize all the electronic records from January 2004 to November 2014, selecting those diagnosed with ocular syphilis. Epidemiological data included: age at diagnosis, gender, affected eye, follow-up period, type of uveitis, laboratory test used, treatment, visual acuity and intraocular pression in the first and last visit, and ocular complications.
Of the 4493 patients seen in the service of uveitis and ocular immunology from January 2004 to November 2014, 50 (1.11%) cases were diagnosed with ocular syphilis. Thirty three (66 %) were female and 17 (34%) men. The average age was 56.34 years (16- 87 years). Of the 50 patients, 7 (14 %) had disease only in the right eye, 12 (24 %) in the left eye, and 31 (62 %) had both eyes afected. The clinical manifestations were: scleritis in 2 (4%) patients, anterior uveitis in 3 (6%) patients, intermediate uveitis in 1 (2%) patient, posterior uveitis 0 (0 %) patients and panuveitis in 44 (88%) patients. The initial and final visual acuity was classified into 5 groups, excellent, good, regular, bad and no functional. With T -student test 0.603.The intraocular pressure of 82 eyes was averaged in 14.47 mmHg, and the averaged of the last visit was 13.66 mm Hg, all by Goldman tonometry .Treatments applied were: benzathine penicillin intravenously in 9 (18%) patients, intramuscular benzathine penicillin in 33 (66%) patients, erythromycin in 6 (12%) patients and 2 (4%) that did not returned. Within the complications more frequently reported were: glaucoma in 13 (26%) patients, cataract in 12 (24%), macular edema in 5 (10%) patients, ocular hypertension in 2 (4%), macular hole in 2 (4%), band keratopathy in 2 (4%), tractional retinal detachment in 2 (4%) patients.
Uveitis caused by syphilis is a pathology observed less frequently due to public health programs, however when present, clinical suspicion, appropriate interrogatory and laboratory test are important to make the diagnosis, specially in patients without previous systemic diagnosis that have bilateral panuveitis.
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