Syphilitic retinitis and uveitis in HIV-positive adults
- PMID: 20659137
- DOI: 10.1111/j.1442-9071.2010.02383.x
Syphilitic retinitis and uveitis in HIV-positive adults
Abstract
Background: The incidence of new infection with syphilis is increasing, particularly in men who have sex with men, with HIV co-infection common. There has been a corresponding increase in ophthalmic manifestations that can be varied in presentation.
Methods: Thirteen consecutive patients with syphilitic uveitis presenting to two ophthalmic departments in Sydney are described.
Results: Twelve patients were male, of whom 10 were homosexual and six HIV-positive. Peripheral retinitis with panuveitis was the commonest ophthalmic presentation (n = 7, 54%), and six cases were initially treated with vitreous tap and intravitreal foscarnet as a precaution in case of viral retinitis. Retinitis was present in six of six (100%) HIV-positive and only one of seven (14%) HIV-negative patients (χ² 10.6, P < 0.01). Other ophthalmic presentations included anterior uveitis, vitritis, multifocal choroiditis, scleritis and papillitis. All patients responded to 10-14 days' intravenous penicillin with good final visual outcomes (6/12 or better in all eyes).
Conclusions: This case series reinforces the importance of considering syphilis in the differential diagnosis of many ocular presentations, but in particular retinitis. Retinitis appears to be the predominant presentation in HIV-infected individuals, suggesting that HIV infection may somehow modulate the disease.
© 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.
Comment in
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Ocular syphilis in HIV-positive individuals.Clin Exp Ophthalmol. 2010 Dec;38(9):829-30. doi: 10.1111/j.1442-9071.2010.02434.x. Clin Exp Ophthalmol. 2010. PMID: 21138510 No abstract available.
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Syphilitic retinitis and uveitis.Clin Exp Ophthalmol. 2011 Sep-Oct;39(7):716. doi: 10.1111/j.1442-9071.2011.02566.x. Epub 2011 Apr 27. Clin Exp Ophthalmol. 2011. PMID: 22452694 No abstract available.
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