Clinical Manifestations and Outcomes of Syphilis-associated Uveitis in Northern Spain

Ocul Immunol Inflamm. 2016;24(2):147-52. doi: 10.3109/09273948.2014.943349. Epub 2014 Aug 14.

Abstract

Purpose: To describe the clinical characteristics and to assess visual prognosis of patients with syphilis-associated uveitis in northern Spain.

Methods: Retrospective review of clinical records in eight general uveitis referral centers.

Results: Since the year 2000, 50 patients have been diagnosed: 31 men and 19 women; median age was 41 (19-76) years. A total of 34% were co-infected with HIV and 24% presented systemic manifestations of syphilis. Median initial visual acuity and vision at last visit in 93 affected eyes was 20/50 (20/20-20/2000) and 20/22 (20/20-20/2000), respectively (p < .0001). The most frequent manifestation was papillitis (33.3%). Fifty percent of eyes with macular edema on admission presented worsening of visual acuity at last visit, whereas frequency of worsening in eyes without edema was 7.1% (p = 0.009).

Conclusions: In our series, patients with syphilitic uveitis were more usually middle-aged men and were frequently co-infected with HIV. Although most patients showed posterior segment involvement, visual prognosis was good.

Keywords: HIV; MSM; Treponema pallidum; syphilis; uveitis.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • CD4 Lymphocyte Count
  • Eye Infections, Bacterial / diagnosis*
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology
  • Female
  • HIV Infections / diagnosis
  • Humans
  • Macular Edema / diagnosis
  • Male
  • Middle Aged
  • Papilledema / diagnosis
  • Prognosis
  • Retrospective Studies
  • Secondary Care Centers
  • Spanien
  • Syphilis / diagnosis*
  • Syphilis / drug therapy
  • Syphilis / microbiology
  • Uveitis / diagnosis*
  • Uveitis / drug therapy
  • Uveitis / microbiology
  • Viral Load
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Anti-Bacterial Agents