Demographic, Clinical and Laboratory Characteristics of Ocular Syphilis: 6-Years Case Series Study From an Eye Center in East-China

Sun, Chuan-bin; Liu, Geng-hao; Wu, Rong; Liu, Zhe

doi:10.3389/fimmu.2022.910337

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…While ocular involvement is rare in syphilis, 7 all of the study patients were diagnosed with the ocular involvement. Delay in diagnosis and improper treatment can lead to irreversible visual loss.…”

Section: Discussionmentioning

confidence: 97%

“…14 We believe that our case series will increase awareness among the clinicians about the OS as the delay in diagnosis and improper treatment can lead to irreversible visual loss. 7,15…”

Section: Discussionmentioning

confidence: 99%

“…Delay in diagnosis and improper treatment can lead to irreversible visual loss. 7 Kaya et al 8 reported a case of syphilis admitted with optic neuritis and then multiple retinitis foci and treated with intravenous pulse steroids without antibiotics. Also, two of our patients were treated with systemic corticosteroid therapy elsewhere due to misdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Never forget ocular syphilis: A case series from a single tertiary centre

Köksaldı,

Nazlı,

Kaya

et al. 2023

Int J STD AIDS

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A retrospective analysis of 10 consecutive patients who had serologically confirmed ocular syphilis between June 2020 and February 2023 was performed. All cases presented with ocular manifestations. Eight patients were diagnosed with syphilis and two patients with syphilis/human immunodeficiency virus co-infection. Type and duration of antibiotic treatments were diverse among the patients. Four patients had intramuscular benzyl-penicillin G 2.4 million units (MU) weekly for three weeks; four, intravenous ceftriaxone for 14 days; one, intravenous penicillin G 24 MU/day for 14 days; and the remaining patient, intravenous penicillin G 24 MU/day for a week and then oral doxycycline for two weeks. As adjunctive therapy to systemic antibiotics, oral corticosteroids in three patients and intravitreal ceftazidime (2.25 mg/0.1 mL) injections in one patient were administered. In conclusion, ocular syphilis is a re-emerging phenomenon; prompt diagnosis and proper antibiotic treatment can prevent serious ocular complications.

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Section: Discussionmentioning

confidence: 97%

“…14 We believe that our case series will increase awareness among the clinicians about the OS as the delay in diagnosis and improper treatment can lead to irreversible visual loss. 7,15…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Never forget ocular syphilis: A case series from a single tertiary centre

Köksaldı,

Nazlı,

Kaya

et al. 2023

Int J STD AIDS

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show abstract

“…13 and the calculation of Goldman-Whitmer coefficient (GWC) also provided a basis for the diagnosis of ocular syphilis. Aqueous humor GWC is also a diagnostic criteria for ocular syphilis ( 5 ). GWC ≥4 indicates that the amount of Treponema -specific antibodies in the aqueous humor significantly exceeds circulating Treponema- specific antibodies, which in consideration of the blood-eye barrier suggests the antibody is produced in situ by ocular tissues ( 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of ocular syphilis in the United Kingdom was 0.3 cases per 1,000,000 people, and 0.6% of syphilis patients had ocular symptoms ( 4 ). A 6 year case study in eastern China demonstrated that ocular syphilis was comorbid in 5.1% of total syphilis cases ( 5 ). In Shanghai, 213 (2.6%) of 8,310 syphilitic patients had ocular manifestations from October 2009 to October 2017 ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: Visual acuity loss as a warning sign of ocular syphilis: A retrospective analysis of 17 cases

et al. 2022

Front. Med.

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ObjectivesTo define the clinical features of ocular syphilis and analyze the cerebrospinal fluid (CSF) of ocular syphilis patients to determine the co-occurrence of neurosyphilis.MethodsThis was a retrospective study of 17 patients (23 eyes) with ocular syphilis admitted to the Fifth People's Hospital, Suzhou, China from September 2017 to December 2021. Clinical manifestations, laboratory tests, treatment, and clinical outcomes were analyzed, and a review was conducted.ResultsEight males (12 eyes) and nine females (11 eyes) were enrolled. Mean patient age was 49.06 ± 3.47 years. The total manifestation time for ocular symptoms ranged from 10 days to 6 years. The cohort was comprised of three cases of early syphilis, four cases of late syphilis, and ten cases of unknown stage. The primary complaints were decreased visual acuity in 15 cases (21 eyes), ptosis in 1 case (1 eye), and loss of light perception in 1 case (1 eye). Cases were diagnosed as chorioretinitis in 7 cases (8 eyes), optic nerve retinitis in 4 cases (6 eyes), optic neuritis in 4 cases (7 eyes), and oculomotor nerve palsy in 1 case (1 eye), syphilitic stromal keratitis in 1 case (1 eye). Serum HIV antibody was positive in one case(Nos.2). All patients had reactive serum Treponema Pallidum Particle Agglutination (TPPA) and Toluidine Red Unheated Serum Test (TRUST). All patients underwent CSF examination. CSF white blood cell count was ≥5 × 106/L in 13 cases, CSF protein was >500 mg/L in 6 cases, TPPA was reactive in 15 cases, and TRUST was reactive in 5 cases. Eleven cases were also diagnosed with neurosyphilis. Patients were treated with either penicillin G sodium or ceftriaxone sodium. At time of discharge, 12 patients reported improved visual acuity. Abnormal serum or CSF examination improved in ten patients during the 6–12 month follow-up.ConclusionVisual acuity loss is a warning indicator of ocular syphilis. Ocular syphilis primarily manifests as posterior uveitis, involving the choroid, retina, and optic nerve, and often co-occurs with neurosyphilis. Effective treatment should be administered immediately to avoid irreversible visual impairment and other serious adverse outcomes.

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Influence of gender on clinical presentation, management practices and outcomes of ocular syphilis

Shields,

Arantes,

Lake

et al. 2024

Sci Rep

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Ocular syphilis is a re-emerging inflammatory eye disease with a clear gender imbalance, disproportionately affecting men. We investigated the impact of gender on the presentation, management practices and clinical outcomes of this condition. Data generated from a study of patients consecutively diagnosed with ocular syphilis who attended a subspecialist uveitis service at one of four hospitals in Brazil over a 30-month period were disaggregated for analysis by gender. Two-hundred and fourteen eyes (161 men and 53 women) of 127 patients (96 men and 31 women) were included. Posterior uveitis was the most common presentation in both men and women (80.1% vs. 66.7%, p > 0.05), but men were significantly more likely to have vitritis as a feature of their disease (49.4% versus 28.8%, p = 0.019). Three eyes of women had nodular anterior scleritis (p = 0.015). Men were more likely to undergo a lumbar puncture to assess for neurosyphilis (71.9% vs. 51.6%, p = 0.048), but men and women undergoing a lumbar puncture were equally likely to have a cerebrospinal fluid abnormality (36.2% vs. 25.0%, p = 0.393). All patients were treated with aqueous penicillin G or ceftriaxone, and there was a trend towards more men receiving adjunctive systemic corticosteroid treatment as part of their management (65.2% vs. 46.7%, p = 0.071). There were no significant differences in the age of presentation, bilaterality of disease, anatomical classification of uveitis, initial or final visual acuity, and rates of ocular complications between men and women. Our findings indicate that ocular syphilis has comparable outcomes in men and women, but that there are differences in the type of ocular inflammation and management practices between the genders.

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Demographic, Clinical and Laboratory Characteristics of Ocular Syphilis: 6-Years Case Series Study From an Eye Center in East-China

Cited by 6 publications

References 17 publications

Never forget ocular syphilis: A case series from a single tertiary centre

Never forget ocular syphilis: A case series from a single tertiary centre

Case report: Visual acuity loss as a warning sign of ocular syphilis: A retrospective analysis of 17 cases

Influence of gender on clinical presentation, management practices and outcomes of ocular syphilis

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