TY - JOUR
T1 - Clinical features and incidence rates of ocular complications in patients with ocular syphilis
AU - Moradi, Ahmadreza
AU - Salek, Sherveen
AU - Daniel, Ebenezer
AU - Gangaputra, Sapna
AU - Ostheimer, Trucian A.
AU - Burkholder, Bryn M.
AU - Leung, Theresa G.
AU - Butler, Nicholas J.
AU - Dunn, James P.
AU - Thorne, Jennifer E.
N1 - Funding Information:
All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and the following were reported. Jennifer E. Thorne serves a consultant for Abbvie (North Chicago, Illinois), Gilead (Foster City, California), Navigant (Chicago, Illinois), and XOMA (Berkeley, California). Jennifer E. Thorne has grant funding from the National Eye Institute (Bethesda, Maryland), and Allergan (Irvine, California). None of the sponsors had any role in the design and conduct of the report; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of this manuscript. The authors indicate no funding support. Contributions of authors: design and conduct of study (A.R.M., S.S.S., E.D., S.G., J.P.D., J.E.T.); collection, management, analysis, and interpretation of data (all authors); preparation of manuscript (A.R.M., S.S.S., J.P.D., J.E.T.); and review and approval of manuscript (all authors).
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Purpose To describe the clinical outcomes of ocular syphilis. Design Retrospective chart review. Methods The charts of patients with ocular syphilis (regardless of human immunodeficiency virus [HIV] status) seen in a uveitis referral center between 1984 and 2014 were reviewed. Results The study included 35 patients (61 eyes). Panuveitis was the most common type of ocular inflammation (28 eyes), independent of HIV status. Thirty-three of 35 patients received systemic antibiotics with 24 patients treated with intravenous (IV) penicillin only. When compared to the HIV-positive patients, HIV-negative patients with ocular syphilis were older (P <.001), were more likely to be female (P =.004), and had poorer visual acuity at presentation (P =.01). During follow-up, the incidence rates of visual impairment were 0.29 per eye-year (EY; 95% confidence interval [CI]: 0.06/EY-0.86/EY) and 0.12/EY (95% CI: 0.01/EY-0.42/EY) among the HIV-negative and the HIV-positive patients, respectively. The incidence of blindness was 0.07/EY (95% CI: 0.009/EY-0.27/EY) and 0.06/EY (95% CI: 0.002/EY-0.35/EY) among the HIV-negative and the HIV-positive patients, respectively. Longer duration of uveitis prior to diagnosis and chorioretinitis in the macula at presentation were associated with 2 Snellen lines of visual loss (P <.01) and visual acuity loss to 20/50 or worse (P =.03) in HIV-negative patients, respectively. Conclusions Syphilis is an uncommon cause of ocular inflammation in both HIV-negative and HIV-positive patients. Visual loss and ocular complications were common among HIV-negative patients even with systemic antibiotic treatment. Delay of diagnosis and chorioretinitis in the macula were associated with visual loss in these patients.
AB - Purpose To describe the clinical outcomes of ocular syphilis. Design Retrospective chart review. Methods The charts of patients with ocular syphilis (regardless of human immunodeficiency virus [HIV] status) seen in a uveitis referral center between 1984 and 2014 were reviewed. Results The study included 35 patients (61 eyes). Panuveitis was the most common type of ocular inflammation (28 eyes), independent of HIV status. Thirty-three of 35 patients received systemic antibiotics with 24 patients treated with intravenous (IV) penicillin only. When compared to the HIV-positive patients, HIV-negative patients with ocular syphilis were older (P <.001), were more likely to be female (P =.004), and had poorer visual acuity at presentation (P =.01). During follow-up, the incidence rates of visual impairment were 0.29 per eye-year (EY; 95% confidence interval [CI]: 0.06/EY-0.86/EY) and 0.12/EY (95% CI: 0.01/EY-0.42/EY) among the HIV-negative and the HIV-positive patients, respectively. The incidence of blindness was 0.07/EY (95% CI: 0.009/EY-0.27/EY) and 0.06/EY (95% CI: 0.002/EY-0.35/EY) among the HIV-negative and the HIV-positive patients, respectively. Longer duration of uveitis prior to diagnosis and chorioretinitis in the macula at presentation were associated with 2 Snellen lines of visual loss (P <.01) and visual acuity loss to 20/50 or worse (P =.03) in HIV-negative patients, respectively. Conclusions Syphilis is an uncommon cause of ocular inflammation in both HIV-negative and HIV-positive patients. Visual loss and ocular complications were common among HIV-negative patients even with systemic antibiotic treatment. Delay of diagnosis and chorioretinitis in the macula were associated with visual loss in these patients.
UR - http://www.scopus.com/inward/record.url?scp=84919819794&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84919819794&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2014.10.030
DO - 10.1016/j.ajo.2014.10.030
M3 - Article
C2 - 25447116
AN - SCOPUS:84919819794
SN - 0002-9394
VL - 159
SP - 334-343.e1
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 2
ER -