Ocular Manifestations of Syphilitic Uveitis in Chinese Patients

Abstract

Posterior uveitis was the most common ocular finding in these investigated Chinese patients with syphilis. Coinfection of syphilis and human immunodeficiency virus was less common in these patients. Syphilis should be considered in the differential diagnosis of patients presenting with large iris granulomas.

Clinical Manifestations and Outcome of Syphilitic Uveitis

“…An overall good visual prognosis in syphilitic uveitis such as found in this large cohort confirms previous studies. [6][7][8][9][10][11] In our study, a higher logMAR VA at the start of syphilis treatment and a delay of more than 12 weeks between the first presentation of uveitis and treatment for syphilis were associated with a statistically significantly higher logMAR VA at 6 months. Possible reasons for diagnostic delay include patients' and doctors' delay.…”

“…Previous studies on prognostic factors in ocular syphilis 6,16,17 showed no difference in visual outcome when comparing the ''classic'' regimen of intravenous penicillin with other antibiotics. But, these studies 6,16,17 were all in small groups, with different kinds of antibiotics and therefore the results should be interpreted cautiously.…”

Yellowish dots in the retina: a finding of ocular syphilis?

“…All manifestations resolved between 2 and 3 weeks after initiation of the treatment (7) . Yang et al (8) described a Chinese patient who presented mutton fat precipitates in the posterior vitreous membrane with retinal vasculitis in both eyes. In addition, Yang and colleagues described three other eyes in two patients, which presented multiple perimacular whitish dots termed as "multiple punctiform retinian precipitates", (8) very similar to those found in our cases.…”

“…Yang et al (8) described a Chinese patient who presented mutton fat precipitates in the posterior vitreous membrane with retinal vasculitis in both eyes. In addition, Yang and colleagues described three other eyes in two patients, which presented multiple perimacular whitish dots termed as "multiple punctiform retinian precipitates", (8) very similar to those found in our cases. Our study, as suggested by these authors, indicates that these precipitates or pale yellowish dots are highly suggestive of ocular syphilis.…”

“…Our study, as suggested by these authors, indicates that these precipitates or pale yellowish dots are highly suggestive of ocular syphilis. Yang et al (8) presumed that they were provenient from treponema collections and inflammatory cells, both pre-and intraretinal.…”