Abstract
Purpose :
Reported cases of ocular syphilis infection are increasing in Canada and across the globe. Our aim was to further characterize the pattern of resurgence and explore the demographics, ophthalmic manifestations and outcomes in patients presenting with ocular syphilis in British Columbia.
Methods :
This is a retrospective chart review of ocular syphilis cases reported to the BC Centre for Disease Control (BCCDC) between January 2013 and December 2016. Ocular syphilis was defined as the presence of signs and symptoms consistent with ocular disease in a patient with laboratory-confirmed syphilis infection of any stage. All cases were assessed by an ophthalmologist, and demographic and clinical data were extracted from the BCCDC’s centralized STI database and the ophthalmologists’ clinical chart.
Results :
There were 39 ocular syphilis cases identified from January 2013 to December 2016 (Figure 1). The median age was 50 (IQR: 40-59.5); 82.1% of the patients were male and 51.3% were diagnosed as HIV positive (Table 1). The clinical chart belonging to 32 patients was available for review at the time of this analysis. 14 patients (43.8%) presented with bilateral ocular complaints, this resulted in 46 affected eyes with available data. The most common ocular presentation was uveitis (93.5%), followed by papillitis (62.2%) and vasculitis (54.3%). Panuveitis was the most frequently encountered type of uveitis (50.0% of all eyes). 77.8% of affected eyes with a visual acuity of 20/50 or worse on presentation, had an improvement of two or more Snellen lines of visual acuity at their final assessment. At presentation, 37.0% of eyes were legally blind (BCVA ≤20/200); legal blindness was reduced to 17.1% at final assessment.
Conclusions :
Ocular syphilis, although rare, is on the rise globally and can result in serious ocular sequalae. A high index of suspicion is required for proper diagnosis and treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.