Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response

Ozlem Sahin,1 Alireza Ziaei1–3 1Department of Ophthalmology/Uveitis, Dunya Goz Hospital, Ankara, Turkey; 2Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA; 3Department of Ophthalmology, Dunya Eye Hospital Ltd, Ankara, Turkey Purpose: To describe the clin...

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Autores principales:	Sahin O, Ziaei A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Ocular syphilis Scleritis Anterior uveitis Intermediate uveitis Retinochoroiditis Panuveitis Optic neuritis Penicillin Methotrexate Human immunodeficiency virus Toxoplasma gondii Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ea103bfad3cb42ec98c7df2cadfdba02
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spelling	oai:doaj.org-article:ea103bfad3cb42ec98c7df2cadfdba022021-12-02T01:01:37ZClinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response1177-5483https://doaj.org/article/ea103bfad3cb42ec98c7df2cadfdba022015-12-01T00:00:00Zhttps://www.dovepress.com/clinical-and-laboratory-characteristics-of-ocular-syphilis-co-infectio-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ozlem Sahin,1 Alireza Ziaei1–3 1Department of Ophthalmology/Uveitis, Dunya Goz Hospital, Ankara, Turkey; 2Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA; 3Department of Ophthalmology, Dunya Eye Hospital Ltd, Ankara, Turkey Purpose: To describe the clinical presentation of patients diagnosed with presumed latent ocular syphilis and congenital ocular syphilis at tertiary referral center in Turkey, and to compare the clinical findings with patients described in other studies, specifically focusing on demographics and co-infections. Methods: This is a retrospective study reviewing the medical records of patients diagnosed with ocular inflammation between January 2012 and June 2014 at a tertiary referral center in Turkey. Ocular syphilis was diagnosed on the basis of non-treponemal and treponemal antibody tests, and cerebrospinal fluid analysis. All the patients diagnosed with ocular syphilis were tested for human immunodeficiency virus (HIV), Toxoplasma gondii, rubella, cytomegalovirus, and herpes. Results: A total of 1,115 patients were evaluated between January 2012 and June 2014, and 12 patients (1.07%) were diagnosed with ocular syphilis based on the inclusion criteria. None of the patients were seropositive for HIV. Two patients were seropositive for T. gondii-specific IgG. Clinical presentations include non-necrotizing anterior scleritis, non-necrotizing sclerokeratitis, anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis, and optic neuritis. All of the patients showed clinical improvement in the level of ocular inflammation with intravenous penicillin 24 million U/day for 10 days. Three patients received additional oral methotrexate as an adjunctive therapy. Two cases received low-dose trimethoprim–sulfamethoxazole. Conclusion: Ocular syphilis is an uncommon cause of ocular inflammation in HIV-negative patients. Central retinochoroiditis is the most common ocular manifestation, and it is the most common cause of visual impairment. Ocular syphilis might present associated with co-infections such as T. gondii in developing countries. Oral methotrexate might be beneficial as an adjunctive therapy for ocular syphilis in resolving the residual intraocular inflammation and cystoid macular edema after specific therapy with intravenous penicillin. Keywords: ocular syphilis, scleritis, uveitis, methotrexate, human immunodeficiency virus, T. gondiiSahin OZiaei ADove Medical PressarticleOcular syphilisScleritisAnterior uveitisIntermediate uveitisRetinochoroiditisPanuveitisOptic neuritisPenicillinMethotrexateHuman immunodeficiency virusToxoplasma gondiiOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2016, Iss Issue 1, Pp 13-28 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ocular syphilis Scleritis Anterior uveitis Intermediate uveitis Retinochoroiditis Panuveitis Optic neuritis Penicillin Methotrexate Human immunodeficiency virus Toxoplasma gondii Ophthalmology RE1-994
spellingShingle	Ocular syphilis Scleritis Anterior uveitis Intermediate uveitis Retinochoroiditis Panuveitis Optic neuritis Penicillin Methotrexate Human immunodeficiency virus Toxoplasma gondii Ophthalmology RE1-994 Sahin O Ziaei A Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
description	Ozlem Sahin,1 Alireza Ziaei1–3 1Department of Ophthalmology/Uveitis, Dunya Goz Hospital, Ankara, Turkey; 2Department of Ophthalmology, Boston University School of Medicine, Boston, MA, USA; 3Department of Ophthalmology, Dunya Eye Hospital Ltd, Ankara, Turkey Purpose: To describe the clinical presentation of patients diagnosed with presumed latent ocular syphilis and congenital ocular syphilis at tertiary referral center in Turkey, and to compare the clinical findings with patients described in other studies, specifically focusing on demographics and co-infections. Methods: This is a retrospective study reviewing the medical records of patients diagnosed with ocular inflammation between January 2012 and June 2014 at a tertiary referral center in Turkey. Ocular syphilis was diagnosed on the basis of non-treponemal and treponemal antibody tests, and cerebrospinal fluid analysis. All the patients diagnosed with ocular syphilis were tested for human immunodeficiency virus (HIV), Toxoplasma gondii, rubella, cytomegalovirus, and herpes. Results: A total of 1,115 patients were evaluated between January 2012 and June 2014, and 12 patients (1.07%) were diagnosed with ocular syphilis based on the inclusion criteria. None of the patients were seropositive for HIV. Two patients were seropositive for T. gondii-specific IgG. Clinical presentations include non-necrotizing anterior scleritis, non-necrotizing sclerokeratitis, anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis, and optic neuritis. All of the patients showed clinical improvement in the level of ocular inflammation with intravenous penicillin 24 million U/day for 10 days. Three patients received additional oral methotrexate as an adjunctive therapy. Two cases received low-dose trimethoprim–sulfamethoxazole. Conclusion: Ocular syphilis is an uncommon cause of ocular inflammation in HIV-negative patients. Central retinochoroiditis is the most common ocular manifestation, and it is the most common cause of visual impairment. Ocular syphilis might present associated with co-infections such as T. gondii in developing countries. Oral methotrexate might be beneficial as an adjunctive therapy for ocular syphilis in resolving the residual intraocular inflammation and cystoid macular edema after specific therapy with intravenous penicillin. Keywords: ocular syphilis, scleritis, uveitis, methotrexate, human immunodeficiency virus, T. gondii
format	article
author	Sahin O Ziaei A
author_facet	Sahin O Ziaei A
author_sort	Sahin O
title	Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
title_short	Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
title_full	Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
title_fullStr	Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
title_full_unstemmed	Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
title_sort	clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/ea103bfad3cb42ec98c7df2cadfdba02
work_keys_str_mv	AT sahino clinicalandlaboratorycharacteristicsofocularsyphiliscoinfectionandtherapyresponse AT ziaeia clinicalandlaboratorycharacteristicsofocularsyphiliscoinfectionandtherapyresponse
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Clinical and laboratory characteristics of ocular syphilis, co-infection, and therapy response

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