Abstract
BackgroundSyphilitic uveitis is reemerging globally, may lead to any type of intraocular inflammation, and is potentially sight-threatening. We aim to characterize clinical features and prognostic factors in patients with syphilitic posterior uveitis.MethodsRetrospective chart review at two tertiary university-based referral centers in Brazil. Clinical data, laboratory results, and treatment outcomes were analyzed. Statistical analysis was performed using Fisher’s exact test for categorical variables and Mann-Whitney U test for continuous variables.ResultsForty-four patients (81 eyes) were consecutively diagnosed with syphilitic posterior uveitis between March 2011 and April 2013.Thirty-one were male (70.5%) and the mean age was 43.8 years (range 15–81). HIV confection was disclosed in 12 patients (29.3%). The most prevalent finding was vitritis (85.2%), followed by retinal involvement (76.4%) and optic disc abnormalities (63.5%). After treatment, mean visual acuity improved from 1.2 (20/320) to 0.6 (20/80; median 20/30), but 19 eyes (23.5%) persisted with ≤ 1.0 (20/200). Factors associated with final visual acuity ≤ 1.0 despite therapy were prior use of systemic corticosteroids (p = 0.001), higher Venereal Disease Research Laboratory titers (p = 0.004), longer duration of symptoms (p = 0.024), and worse initial VA (p < 0.001).ConclusionsSyphilitic uveitis is reemerging. Delayed diagnosis and inadvertent use of systemic corticosteroids are potentially modifiable prognostic factors to be considered for possibly improving outcomes.
Highlights
Syphilitic uveitis is reemerging globally, may lead to any type of intraocular inflammation, and is potentially sight-threatening
Syphilis may lead to any type of intraocular inflammation, with distinct forms of syphilitic retinitis being characterized in the last decade [7,8,9]
In the context of the reemergence of this old disease and in parallel to other smaller reports [10, 11, 13, 14, 17,18,19], we aim to investigate clinical features and potential demographic and clinical prognostic factors in a relatively larger series of patients diagnosed with syphilitic posterior uveitis during 2 years at two university-based referral centers in Brazil
Summary
Syphilitic uveitis is reemerging globally, may lead to any type of intraocular inflammation, and is potentially sight-threatening. We aim to characterize clinical features and prognostic factors in patients with syphilitic posterior uveitis. Potentially sight-threatening disease caused by the spirochete Treponema pallidum. The incidence of syphilis has been increasing for more than 15 years, Syphilis may lead to any type of intraocular inflammation, with distinct forms of syphilitic retinitis being characterized in the last decade [7,8,9]. Few studies tried to characterize factors possibly associated with worse visual outcome in syphilitic uveitis.
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