Abstract
Purpose :
Syphilis is a reemerging disease that has become more prevalent in recent years. A 2021 study by the Center for Disease Control (CDC) indicated a 74% increase in cases of syphilis compared to that in 2015. Syphilis can go undetected for many years in its latent form and can lead to the presentation of ocular syphilis at any stage. Common manifestations of ocular syphilis include anterior and posterior uveitis and can lead to vision loss from multiple causes. The purpose of this study is to present characteristics, clinical presentations, and visual outcomes in patients that presented to Tampa General Hospital (TGH) in Hillsborough County, Florida with ocular syphilis.
Methods :
A total of 63 patients were included in this retrospective observational study. They presented to TGH between July 2015 and July 2021 . Collected data included baseline demographic information, presence of comorbid sexually transmitted infections (STIs), visual acuity, intraocular pressure, ocular exam findings, and the presence of other ocular pathology. Visual acuity was measured at initial exam, one week and one month.
Results :
Among 63 patients evaluated, 45 (71.4%) were male and 18 (28.6%) were women with an average age of 48.7 years. 16 patients identified as White (25.4%), 44 as African American (69.8%), and 3 as Hispanic (4.8%). Over the time frame of interest, 4 patients were diagnosed with syphilis in 2015, 14 in 2016, 5 in 2017, 7 in 2018, 8 in 2019, 16 in 2020, and 16 in 2021. Comorbid STIs were confirmed in 29 patients (46.0%) with 23 patients having a positive HIV status (36.5%). The average logMAR at the initial visit was 0.49 (20/62 Snellen, n=59), followed by averages of 0.57 (20/74 Snellen, n=20) at one-week follow-up and 0.38 (20/48 Snellen, n=20) at one month follow-up.
Conclusions :
The increasing cases of syphilis are concerning from an ophthalmologic perspective due to the adverse sequelae associated with ocular syphilis. The findings of this study indicate a steady increase from 2015 to 2021 in cases of ocular syphilis, increasing from 4 cases in 2015 to 16 cases in 2021. Comorbid STIs were common in these patients, as 46% were affected. Prompt diagnosis and treatment is vital to preserving and recovering vision. Visual acuity improved from logMAR 0.49 at initial visit to 0.38 at one month follow-up. Ocular syphilis is a growing public health concern, indicating an increased need for awareness, prevention, and screening.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.