Clinical Ophthalmology (Oct 2023)
Clinical Features of Syphilis Patients with Ocular Symptoms as the Initial Manifestation
Abstract
Haruka Matsumoto,1 Shigenari Suzuki,1 Mayumi Nagata,1 Tadashi Senoo,1 Meri Watanabe,2 Hidetoshi Kawashima2 1Department of Ophthalmology, Dokkyo Medical University, Mibu, Japan; 2Department of Ophthalmology, Jichi Medical University, Shimotsuke, JapanCorrespondence: Haruka Matsumoto, Department of Ophthalmology, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga-gun, Mibu, Tochigi, 321-0293, Japan, Tel +81 282 86 1111, Fax +81 282 86 0630, Email [email protected]: This study aimed to investigate the clinical features of patients with syphilis having ocular symptoms as the initial manifestation.Patients and Methods: Eleven patients diagnosed with ocular syphilis at Dokkyo Medical University Hospital and Jichi Medical University Hospital between November 2018 and April 2022 were studied retrospectively.Results: Six patients were diagnosed with secondary, three were latent, and one was tertiary stage syphilis. Ten out of 11 patients underwent cerebrospinal fluid analysis, and 1 refused. Nine out of 10 patients tested positive, of which 4 presented with neurological symptoms and the others were asymptomatic. Nine out of 11 patients tested negative for human immunodeficiency virus. Antiluetic therapy was administered to 10 out of 11 patients, which improved or maintained visual acuity at − 0.1 logMAR in 9 patients. One patient achieved the best-corrected visual acuity − 0.1 logMAR in one eye, whereas the other showed no improvement due to severe chorioretinal degeneration.Conclusion: Ocular syphilis presents with various clinical findings and has no significant ocular manifestations without acute syphilitic posterior placoid chorioretinitis. Patients diagnosed with syphilis based on ocular symptoms should undergo cerebrospinal fluid analysis.Keywords: syphilis, ocular syphilis, secondary stage syphilis, antiluetic therapy, neurosyphilis, sexually transmitted disease
