Increase in Ocular Syphilis Cases at Ophthalmologic Reference Center, France, 2012-2015

Abstract

We describe the frequency, demographic and clinical features, and visual outcomes of ocular syphilis infections observed during 2012-2015 at a tertiary reference center in Paris, France. Twenty-one cases (29 eyes) were identified. The occurrence of ocular syphilis increased from 1 case in 2012 to 5 cases in 2013, 6 cases in 2014, and 9 cases in 2015 (2.22-25.21/1,000 individual patients/year for the period). Among case-patients, an annual 20%-33% were co-infected with HIV. Seventy-six percent of ocular syphilis infections occurred in men who have sex with men. Seventy-five percent of case-patients had a good final visual outcome (best-corrected visual acuity >0.3 logMAR score). Visual outcome was worse for HIV-positive patients than for HIV-negative patients (p = 0.0139). At follow-up, the best visual outcomes were observed in patients whose mean time from first ocular symptom to consultation was 15 days (SD +19 days).

Keywords: France; MSM; bacterial infections; epidemiology; men who have sex with men; neurosyphilis; ocular; ophthalmologic; sexually transmitted infections; syphilis; uveitis.

Figure 1

Number of newly diagnosed ocular syphilis cases among patients seen at a uveitis clinic, Paris, France, 2012–2015: 2012, 1 case; 2013, 5 cases; 2014, 6 cases; 2015, 9 cases.

Figure 2

Presence of neurosyphilis and stages of syphilis in 21 patients with ocular syphilis seen at a uveitis clinic, Paris, France, 2012–2015.

Figure 3

Anatomical sites of ocular inflammation in 21 patients with ocular syphilis seen at a uveitis clinic, Paris, France, 2012–2015.

Figure 4

Visual acuity at initial examination versus final acuity (r = 0.5) in 21 patients with ocular syphilis seen at a uveitis clinic, Paris, France, 2012–2015.