Abstract
Purpose: :
To Describe the clinical findings, age of onset and visual outcome in patients with diagnosis of ocular syphilis.
Methods: :
Retrospective analysis of data from patients with Ocular Syphilis at a referal center in Mexico City from January 2001 to June 2007. Patients included in this study were those who had diagnosis of Syphilis corroborated with laboratory analysis and clinical features. Patients were excluded from the study if clinical record was incomplete.
Results: :
A total of 18 patients with ocular syphilis were identified, 1 patient was eliminated for lack of information in follow-up, a total of 17 patients were included in this study, 6 female and 11 male. The mean age was 63.22 year (SD 10.98). Mean follow-up was 6.4 months (3.2 -9.3). The diagnosis was performed with ocular findings, positive FTA-ABS analysis and positive Venereal Disease Research Laboratory (VDRL) in two separate ocassions. 90% of the patients didn`t know they were infected with Treponema pallidum. All patients were systemically treated like neurosyphilis with intravenous penicillin or Oral Erythromycin if history of hipersensibility was reported.The Clinical findings were divided by site of presentation; anterior segment manifestations (8), posterior segment manifestation (7) and panuveitis (2) . Clinical findings in anterior segment were non granulomatous uveitis in 5 patients (29.41%), non necrotizing anterior scleritis in 2 (11.76%), inactive interstitial Keratitis in 1 (5.88%). Posterior segment manifestations were Neuroretinitis in 4 patients (23.52%) and chorioretinitis in 3 (17.64%). Granulomatous Panuveitis was present in 2 patients (11.76%). One patient was identified as HIV positive.Visual acuity (VA) levels were measured using a Snellen chart, Pre-treatment VA ranged from 20/25 to light perception. Post-treatment VA ranged from 20/20 to 5/200. Visual acuity improved in 13 (76.4%). 2 lines or more in 10 (58.76%), no change in 3 (11.76%) and decreased en 1 (5.88%).
Conclusions: :
Mean age of onset was 63.22 years corresponding with other literature reports. Ocular Syphillis must be confirmed with Laboratory analysis . In our study the most common manifestation was anterior uveitis despite the fact that other series report posterior uveitis as the principal manifestation, this could explain the good visual acuity reported in our serie. Patients with posterior ocular manifestations were associated with worse final VA during follow-up. Ocular inflammation was controlled in most of the patients with systemic and topical treatment.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • uvea • bacterial disease