Reversal of Severe Visual Loss from Syphilitic Chorioretinitis Following Penicillin Treatment

Warner, Evan J.; Chen, Yanjun

doi:10.3109/01658107.2015.1077389

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…The true rate of ocular syphilis may be higher than we have reported, because patients with mild visual symptoms may not have been detected by either the clinician or the patient themselves. Whilst ocular syphilis is a treatable disease if it is diagnosed promptly and treated properly delays can lead to serious sequelae including lifelong blindness [24][25][26] . In the pre-antibiotic era, about 9% to 12% of patients with ocular syphilis developed blindness.…”

Section: Discussionmentioning

confidence: 99%

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

Gao

Yan

et al. 2020

Acad Dermatol Venereol

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Background Ocular involvement can occur at any stage of syphilis. Prompt diagnosis and proper treatment of ocular syphilis are vital to avoid long‐term consequences. Objectives To describe the risk factors for ocular syphilis and clinical features of blindness caused by syphilis. Methods We report risk factors for ocular syphilis amongst patients seen at the Shanghai Skin Disease Hospital between October 2009 and October 2017. We identify patients with ocular syphilis resulting in blindness and report the clinical characteristics, laboratory findings and treatment outcomes of these patients. Results A total of 8310 new cases of syphilis were seen, of which 213 patients had ocular disease and 50 patients had blindness due to syphilis. Increasing age and higher RPR titres were associated with ocular involvement but there was no association with HIV status. Blindness in syphilis was restricted predominantly to patients with optic nerve involvement and not patients with isolated uveitis. Fifty patients (and a total of 67 eyes) met the WHO definition of blindness prior to treatment for syphilis. At the end of follow‐up, vision had improved in 24 of 67 eyes (35.8%) after treatment. Successful treatment of uveitis was associated with the best improvement in visual acuity, whilst patient with underlying optic atrophy prior to treatment had the worst visual outcome. Conclusions Ocular involvement is an important manifestation of syphilis which may result in blindness. Our data demonstrate outcomes for ocular syphilis are poor if detected late; early recognition and diagnosis is therefore vital to avoid permanent visual loss.

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Section: Discussionmentioning

confidence: 99%

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

Gao

Yan

et al. 2020

Acad Dermatol Venereol

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Could ceftriaxone be a viable alternative to penicillin for the treatment of ocular syphilis?

Gu,

Lu,

Yang

et al. 2024

Antimicrob Agents Chemother

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This study was conducted to compare the effectiveness of ceftriaxone with that of aqueous crystalline penicillin G in treating ocular syphilis. We conducted a retrospective study from 2010 to 2021. Syphilis patients were administered either ceftriaxone (2 g intravenously daily for 14 days) or aqueous crystalline penicillin G [4 million units (MU) intravenously every 4 h for 14 days] as therapeutic interventions. Subsequently, we utilized these two groups to assess the serological results, cerebrospinal fluid analysis, and visual acuity at time intervals spanning 3 to 6 months post-treatment. A total of 205 patients were included, with 34 assigned to the ceftriaxone group and 171 to the penicillin group. The median age of patients was 56 years, with an interquartile range of 49–62 years, and 137 of them (66.8%) were male. Between 3 and 6 months after treatment, 13 patients (38.2%) in the ceftriaxone group and 82 patients (48.0%) in the penicillin group demonstrated effective treatment based on the clinical and laboratory parameters. The crude odds ratio (OR) was 0.672 (95% confidence interval [CI]: 0.316–1.428, P = 0.301), indicating no significant difference in effectiveness between the two groups. Thirty patients (17.5%) in the penicillin group and six patients (17.6%) in the ceftriaxone group did not experience successful outcomes. Notably, no serious adverse effects were reported in both the groups. There was no significant difference in the effectiveness of ceftriaxone and aqueous crystalline penicillin G in treating ocular syphilis. The administration of ceftriaxone without requiring hospitalization presents a convenient and safe alternative treatment option for ocular syphilis.

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Reversal of Severe Visual Loss from Syphilitic Chorioretinitis Following Penicillin Treatment

Cited by 2 publications

References 9 publications

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

Could ceftriaxone be a viable alternative to penicillin for the treatment of ocular syphilis?

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