Abstract

AbstractPurpose Treatment of HIV with highly active antiretroviral therapy (HAART) has extended life expectancy with many years. There are signs that the better prognosis of this formerly deadly disease has a negative spin‐off, which is a frequent occurrence of the coexistence of HIV and ocular syphilis.Methods We collected the cases of ocular syphilis in the last 7 years in a general hospital ( Medisch Spectrum Twente, the Netherlands). Furthermore, a literature search was performed to identify papers on the clinical manifestation of this disease, especially in relation to HIV‐infection.Results We analysed the characteristics of 3 patients with ocular syphilis, 2 of these patients had co‐infection with HIV. Several different disease manifestations of Treponema Pallidum infection in the eye were observed, especially with regard to the optic nerve, the macular area and the retinal periphery. Treatment with intravenous Penicillin was successful in all patients, though some eyes developed irreversible loss of function.Conclusion Especially in immune compromised patients ocular syphilis is an acute sight threatening disease, with specific diagnostic challenges, requiring immediate intravenous treatment.

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