Ocular Syphilis Presenting As Non-arteritic Anterior Ischemic Optic Neuropathy

Abstract

Syphilis is a sexually transmitted disease caused by the spirochetal bacteria Treponema pallidum. It can cross the blood-brain barrier within days of the infection, causing neurosyphilis and ocular syphilis at any stage of the disease. Ocular syphilis can manifest in any part of the eye but usually as posterior uveitis and panuveitis or various types of inflammatory or immune-mediated optic neuritis. Misdiagnosing ocular syphilis as a non-infectious disease has been reported even when seen by ophthalmologists due to the wide variety of possible presentations. In this case report, we describe a case of ocular syphilis that presented with a nonarteritic anterior ischemic optic neuropathy (NA-AION), which to our knowledge, has not been described before in the literature.

Non-Arteritic Anterior Ischemic Optic Neuropathy (NA-AION): A Comprehensive Overview

“…sumatriptan: the use of sumatriptan for migraine has been linked with the development of NA-AION, and is likely caused by the vasoconstrictory effect of the drug [86]; f. drugs used to treat cardiovascular diseases: the use of anti-thrombotic agents, beta-blockers, statins, aggressive anti-hypertensive therapy and night-time dosing of anti-hypertensives have been linked with the development of NA-AION [14]. The causal association is obviously unclear considering that these drugs are used in subjects with vascular risk factors that may act as predisposing or precipitating factors for NA-AION; -Infections and vaccinations: NA-AION cases have been described soon after various infections, including syphilis, rickettsia, hepatitis C virus, borrelia burgdorferi, herpes simplex, Chlamydia pneumoniae [87,88] and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2] infection, the causal agent of COVID-19 disease [89,90]. Moreover, an association between NA-AION and vaccinations against influenza [91] and COVID-19 disease has been reported [92,93].…”