Posterior syphilitic uveitis: clinical characteristics, co-infection with HIV, response to treatment

Li, Sing Your; Birnbaum, Andrea D.; Tessler, Howard H.; Goldstein, Debra A.

doi:10.1007/s10384-011-0053-z

Cited by 26 publications

(12 citation statements)

References 30 publications

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“…Coinfection of syphilis and HIV was only observed in one patient, and the sexual history was difficult to assess in our study because of traditional Chinese customs. Compared with other reports [4, 10], the frequency of co-infection of HIV in our patients with syphilitic uveitis was much lower, which may be due to the low prevalence of HIV in China, especially in northern China [16]. There were more female patients than male patients in our cohort.…”

Section: Discussioncontrasting

confidence: 73%

Characteristics of syphilitic uveitis in northern China

Zhang¹,

Du²,

Ma³

et al. 2017

BMC Ophthalmol

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BackgroundTo describe the characteristics of patients with syphilitic uveitis in northern China.MethodsA case series of 21 patients (33 eyes) diagnosed with syphilitic uveitis from 2011 to 2016 at a tertiary center in northern China was retrospectively analyzed.ResultsTwenty-one patients (33 eyes) were diagnosed as syphilitic uveitis. Posterior segment involvement was found in 32 eyes (97.0%). Vitreous haze, neuroretinitis, and posterior placoid chorioretinitis were mainly found in patients with a relatively short duration of the disease, while diffuse chorioretinitis, pseudoretinitis pigmentosa, cystoid macular edema, and epiretinal membrane were found in patients with relatively long duration of ocular involvement. A low best-corrected visual acuity (P = 0.022) and a delay of syphilis treatment (P < 0.001) were associated with a significantly worse visual outcome.ConclusionsSyphilitic uveitis should be included in the differential diagnosis of any form of posterior ocular inflammation. The pattern of ocular involvement may change with the disease progression.

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Section: Discussioncontrasting

confidence: 73%

Characteristics of syphilitic uveitis in northern China

Zhang¹,

Du²,

Ma³

et al. 2017

BMC Ophthalmol

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“…Recent reports by Fonollosa et al and Li et al noted high rates of HIV co-infection (70-80%) and it has been proposed that the era of highly active anti-retroviral therapy (HAART) with prolonged survival of HIV-positive patients might have contributed to the rising rates of syphilitic uveitis. 13,24 Taking into account the 2 patients who declined HIV testing, our possible range of HIV co-infection would be 25.0-41.2%, which is lower than that quoted in previous studies. In an earlier local case series from Singapore, Chio et al reported no patients with concomitant HIV co-infection.…”

Section: Discussionmentioning

confidence: 55%

“…Similar studies of posterior segment manifestations have shown great variability in the distribution of these findings. 13,14 Posterior placoid chorioretinitis, a characteristic but not pathognomonic feature of syphilitic posterior uveitis, was present in both eyes of one of our HIV-negative patients (patient 7). Characteristic fine pigmented changes within a circumscribed lesion that demonstrated disk leakage and paramacular choroidal hypofluoresence on fluorescein angiography were seen.…”

Section: Discussionmentioning

confidence: 70%

Syphilitic Uveitis in a Singaporean Population

Yap

Tan

Chio

et al. 2013

Ocular Immunology and Inflammation

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“…Antibacterial agents were used as monotherapy in 286 patients in 15 studies [14, 17, 20, 23, 27, 30, 34, 35, 37, 39, 40, 42–45]. The mean age of the patients ranged from 37 to 58 years.…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies [17, 21, 22, 24, 27, 28, 30, 36] involving 190 patients (318 eyes) reported ocular complications that included cataract ( n = 41), ocular hypertension ( n = 15), posterior synechiae ( n = 15), chorioretinal scarring ( n = 12), epiretinal membrane ( n = 12), macular edema ( n = 10), optic disc atrophy ( n = 10), and retinal detachment ( n = 8) (Table 5). …”

Section: Resultsmentioning

confidence: 99%

Clinical Features and Treatments of Syphilitic Uveitis: A Systematic Review and Meta-Analysis

Zhang

Zhu

2017

Journal of Ophthalmology

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Purpose To investigate the clinical features and efficacies of treatments for syphilitic uveitis. Methods PubMed was searched for studies of syphilitic uveitis published between January 1990 and October 2016. The clinical features were summarized and appraised. The pooled success rate was defined as an improved or maintained final visual acuity and was calculated with 95% confidence intervals (CIs). Heterogeneity, subgroup analysis, sensitivity analysis, and publication bias were assessed. Results Thirty-two studies involving 670 patients were analyzed. The most common type of syphilitic uveitis was papillitis. The pooled success rate was 0.91 (95% CI 0.84–0.97) for antibacterial agents alone (15 studies, 286 patients); 0.95 (95% CI 0.91–0.98) for antibacterial agents and systemic corticosteroids combined (11 studies, 245 patients); and 0.91 (95% CI 0.80–0.98) for antibacterial agents, systemic corticosteroids, and other immunosuppressants combined (3 studies, 73 patients). Subgroup analyses revealed no correlations of the efficacy of antibacterial agent monotherapy with study characteristics, such as human immunodeficiency virus coinfection status. Conclusions This systematic review and meta-analysis revealed the efficacy of antibacterial agents for treating syphilitic uveitis. Coadministration of systemic corticosteroids or immunosuppressants did not elicit further improvements in the clinical outcomes of antibacterial agents.

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Posterior syphilitic uveitis: clinical characteristics, co-infection with HIV, response to treatment

Abstract: In this series, syphilitic posterior uveitis presented only in men, and all with available data were MSM. The majority were concomitantly infected with HIV. Clinical presentations varied and all patients demonstrated either significant improvement or complete resolution of inflammation.

Cited by 26 publications

References 30 publications

Characteristics of syphilitic uveitis in northern China

Characteristics of syphilitic uveitis in northern China

Syphilitic Uveitis in a Singaporean Population

Clinical Features and Treatments of Syphilitic Uveitis: A Systematic Review and Meta-Analysis

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