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Case Reports
. 2010;3(4):361-4.
doi: 10.3980/j.issn.2222-3959.2010.04.21. Epub 2010 Dec 18.

Syphilitic uveitis: report of 3 cases

Shin Wei Pan  1 , Nor Sharina Yusof, Wan Hazabbah Wan Hitam, Raja Azmi Mohd Noor, Zunaina Embong
Affiliations
Case Reports

Syphilitic uveitis: report of 3 cases

Shin Wei Pan et al. Int J Ophthalmol. 2010.

Abstract

Aim: To evaluate the clinical manifestations and visual outcome of syphilitic uveitis patients.

Methods: Case series of three patients with syphilitic uveitis who were managed in Hospital USM.

Results: Three patients were diagnosed to have uveitis secondary to Syphilis. All three patients were not known to have syphilis prior to presentation but have positive history of sexual promiscuity. All patients presented with progressive blurring of vision for average of one-month duration. Two of them have association with fever, ocular pain and floaters. Visual acuity at presentation ranges from 6/12 to hand movement. Mild anterior uveitis (non-granulomatous), vitritis and papillitis were presence in all the patients. First patient has multifocal chorioretinitis with exudative retinal detachment. The second patient presented with exudative retinal detachment while the third patient has chorioretinitis only. All the patients were treated with intramuscular benzyl-penicillin 2.4 MU weekly for 4 weeks and two of them received oral doxycycline 200mg twice daily for 3 months. The uveitis responded well to the treatment and two of them showed dramatic visual improvement from 6/120 to 6/21 and 6/12 to 6/6. The one with worse outcome was confirmed to have positive retroviral.

Conclusion: Ocular syphilis presented here as non-granulomatous inflammation associated with exudative retinal detachment. Final visual outcome is generally good despite slow improvement after treatment.

Keywords: chorioretinitis; exudative retinal detachment; syphilis; uveitis.

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Figures

Figure 1
Figure 1. Fundus showed hyperemic swollen optic disc with multi focal chorioretinitis at the peripheral of the retina
A: Right; B: Left
Figure 2
Figure 2. Fundus showed swollen optic discs with flamed shaped hemorrhages and congested peripapillary veins
A: Right; B: Left
Figure 3
Figure 3. Fundus showed hazy view due to vitritis with hyperemic optic disc, retinitis and vasculitis
A: Right; B: Left
See this image and copyright information in PMC

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