Non-human Immunodeficiency Virus-related Ocular Syphilis in a Korean Population: Clinical Manifestations and Treatment Outcomes
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Purpose: To describe the clinical manifestations and treatment outcomes of ocular syphilis in patients withouthuman immunodeficiency virus (HIV) infection. Methods: A total of 45 eyes from 39 patients with ocular syphilis confirmed by serologic tests were reviewedretrospectively. The included cases were all non-HIV-infected patients presenting with intraocular inflammationfrom 2002 to 2014 at Kyung Hee University Hospital. Medical records of 45 eyes were analyzed and includedbest-corrected visual acuity and ophthalmologic examination findings of the anterior and posterior segmentsto determine the focus of inflammation. Optical coherence tomography and fluorescein angiography findingsas well as both medical and surgical management were also analyzed. Results: The mean patient age was 61.0 years (range, 37 to 89 years). Bilateral ocular involvement occurredin 6 patients (15.4%), and diagnoses at presentation were most frequently related to posterior uveitis (38%),followed by panuveitis (29%) and optic neuritis (11%). Isolated interstitial keratitis and intermediate uveitis wereuncommon (4%, both). Twenty-eight eyes (62.2%) were treated with penicillin, and 11 eyes (24.4%) underwentsurgical treatment. The mean baseline best corrected visual acuity was 0.79 ± 0.59 (mean ± standard deviation,logarithm of the minimum angle of resolution) and significantly improved to 0.60 ± 0.63 at the final follow-up after treatment (p = 0.019). Mean visual improvement was significantly greater in the penicillin-treatedgroup (p = 0.001). Visual impairment at the final visit occurred in 11 eyes (24.4%). Among the visual impairmentgroup, 10 eyes (90.1%) had posterior segment-involving uveitis. Conclusions: Visual outcomes of treated, non-HIV-related ocular syphilis were favorable regardless of time topresentation. Posterior segment-involving uveitis at presentation was associated with poor visual outcome.
Abstract
Purpose: To describe the clinical manifestations and treatment outcomes of ocular syphilis in patients withouthuman immunodeficiency virus (HIV) infection. Methods: A total of 45 eyes from 39 patients with ocular syphilis confirmed by serologic tests were reviewedretrospectively. The included cases were all non-HIV-infected patients presenting with intraocular inflammationfrom 2002 to 2014 at Kyung Hee University Hospital. Medical records of 45 eyes were analyzed and includedbest-corrected visual acuity and ophthalmologic examination findings of the anterior and posterior segmentsto determine the focus of inflammation. Optical coherence tomography and fluorescein angiography findingsas well as both medical and surgical management were also analyzed. Results: The mean patient age was 61.0 years (range, 37 to 89 years). Bilateral ocular involvement occurredin 6 patients (15.4%), and diagnoses at presentation were most frequently related to posterior uveitis (38%),followed by panuveitis (29%) and optic neuritis (11%). Isolated interstitial keratitis and intermediate uveitis wereuncommon (4%, both). Twenty-eight eyes (62.2%) were treated with penicillin, and 11 eyes (24.4%) underwentsurgical treatment. The mean baseline best corrected visual acuity was 0.79 ± 0.59 (mean ± standard deviation,logarithm of the minimum angle of resolution) and significantly improved to 0.60 ± 0.63 at the final follow-up after treatment (p = 0.019). Mean visual improvement was significantly greater in the penicillin-treatedgroup (p = 0.001). Visual impairment at the final visit occurred in 11 eyes (24.4%). Among the visual impairmentgroup, 10 eyes (90.1%) had posterior segment-involving uveitis. Conclusions: Visual outcomes of treated, non-HIV-related ocular syphilis were favorable regardless of time topresentation. Posterior segment-involving uveitis at presentation was associated with poor visual outcome.
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