Main ophthalmological manifestations in patients diagnosed with ocular syphilis attended at Instituto Nacional De Rehabilitacion

Abstract

AbstractPurpose: Describe the ophthalmological manifestations of patients diagnosed with ocular syphilis at the Instituto Nacional de Rehabilitación, and the main complications derived from ocular pathology.Methods: Adult patients diagnosed with ocular syphilis, treated in the ophthalmology service during the period 2015–2021. A descriptive analysis of the collected data (SPSS 25.0 for Macintosh) was performed, comparing the frequency of ocular manifestations recorded, the frequency of complications reported in patients and analysing the best corrected visual acuity before treatment and after treatment.Results: 18 patients and 34 eyes were analysed, 16 eyes manifested with posterior uveitis (47.1%), 15 patients with panuveitis (44.1%) and three eyes presented anterior uveitis (8.8%). Of the HIV‐positive eyes (N = 12), posterior uveitis (50%) and panuveitis (50%) occurred equally. Retinal vasculitis (17.7%) was the most frequent finding, followed by vitritis (14.9%) and presence of cellularity in the anterior chamber (11.3%). The main complications reported were ocular hypertension/glaucoma in six eyes (17.65%), posterior segment involvement in six eyes (17.65%) and cataract in four eyes (11.76%). Regarding posterior segment complications, three eyes presented epiretinal membrane (50.0%), cystic macular edema in two eyes (33.33%) and choroidal neovascularization in one eye (16.67%). Best‐corrected visual acuity at presentation was a mean of 0.67 (±0.84) on the LogMAR scale, and best‐corrected visual acuity at the last post treatment visit was a mean of 0.43 (±0.61).Conclusions: Syphilis should be a diagnostic possibility in patients with intraocular inflammation because it can affect any ocular structure, vasculitis in our population was predominant as a clinical manifestation, serology for HIV and lumbar puncture should be performed in these patients; should always be treated with the neurosyphilis regimen by intravenous administration of crystalline penicillin G for 14 days.