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We report the case of a 34-year-old male patient who presented to the Ophthalmology Department because of a decline in visual acuity in both eyes. The patient was diagnosed with anterior and posterior uveitis in the right eye and optic neuritis in the left eye, secondary to syphilis. Topical and systemic treatments were implemented, leading to a gradual improvement in the patient’s condition. Considering the rising global incidence of syphilis and the non-specific ocular manifestations it may present, the diagnosis should be considered in patients with ocular inflammatory conditions of unknown etiology.

In recent years, the literature has been discussing the issues of diagnosis and managing damaged eye patients who suffer from syphilis/HIV coinfection. We present a clinical case of syphilitic uveitis in the patient’s third reinfection of syphilis, which occurred during a long-term HIV infection. The causes for insufficient treatment effectiveness are analyzed.

Introduction: Syphilis presents with diverse clinical manifestations, posing challenges for diagnosis, especially in the fast-paced emergency department (ED) setting. Case Report: We report a rare case of unilateral syphilitic uveitis in an individual who had been sexually abstinent for 13 years. Using ocular point-of-care ultrasound in the ED, we successfully diagnosed this uncommon ocular manifestation. Conclusion: Our case highlights the diagnostic challenges of ocular syphilis and emphasizes the crucial nature of timely identification. Collaborative efforts with specialties such as ophthalmology are essential in overcoming these challenges. [ABSTRACT FROM AUTHOR]

The paper is focused on diagnosing eye structure lesions in patients with syphilis. Two clinical cases are described: a case of syphilitic uveitis in early syphilis and optic nerve atrophy in late syphilis. The main purpose is to increase the awareness of ophthalmologists about specific eye diseases in syphilis and the need for early detection of such pathologies. For citation: Bokhonovich D.V., Loseva O.K., Ryabtseva A.A., Kovrizhkina A.A., Yudakova V.M., Chernysheva N.V. Eye lesions in syphilis. Russian ophthalmological journal. 2018; 11 (2): 46-53. doi: 10.21516/2072-0076-2018-11-2-46-53 (In Russian).

Abstract Background To describe the characteristics of patients with syphilitic uveitis in northern China. Methods A case series of 21 patients (33 eyes) diagnosed with syphilitic uveitis from 2011 to 2016 at a tertiary center in northern China was retrospectively analyzed. Results Twenty-one patients (33 eyes) were diagnosed as syphilitic uveitis. Posterior segment involvement was found in 32 eyes (97.0%). Vitreous haze, neuroretinitis, and posterior placoid chorioretinitis were mainly found in patients with a relatively short duration of the disease, while diffuse chorioretinitis, pseudoretinitis pigmentosa, cystoid macular edema, and epiretinal membrane were found in patients with relatively long duration of ocular involvement. A low best-corrected visual acuity (P = 0.022) and a delay of syphilis treatment (P < 0.001) were associated with a significantly worse visual outcome. Conclusions Syphilitic uveitis should be included in the differential diagnosis of any form of posterior ocular inflammation. The pattern of ocular involvement may change with the disease progression.

Purpose: To report a case of atypical syphilitic uveitis complicated with retinal vasculitis, proliferative retinopathy, and vitreous hemorrhage in which vitreous surgery was useful for the diagnosis and treatment. Case Report: A 38-year-old female was referred to our hospital after noticing visual disturbance in her right eye. Fundoscopy examination of that eye revealed retinal phlebitis accompanied by retinal hemorrhage and soft exudate, and remarkable exudative changes in the retinal vessels from the upper arcade to the macula region. After a blood examination, a serological test showed positive for syphilis; however, systemic findings were scarce. Syphilitic uveitis was suspected, so we administered treatment for syphilis, anticoagulant treatment for retinal vasculitis, steroids for intraocular inflammation, and photocoagulation for the retinal nonperfusion area. However, her visual acuity (VA) decreased to 30 cm/counting fingers due to vitreous hemorrhage resulting from fibrovascular membrane at the optic disc. Since the vitreous hemorrhage was insufficiently absorbed, vitreous surgery was performed to remove the hemorrhage and fibrovascular tissue. Following surgery, the uveitis and retinal vasculitis subsided, and her corrected VA improved to 0.3. Postoperative examination of a fixed quantity of collected vitreous fluid for syphilis showed a Treponema pallidum hemagglutination value of 5,120 times the normal amount, thus confirming the syphilitic uveitis diagnosis. Conclusions: Our findings show that when observing patients with obstructive retinal vasculitis of unknown causes, syphilitic uveitis should be considered as a differential diagnosis, and that vitreous surgery is useful for the diagnosis and treatment of atypical syphilitic uveitis which has progressed to proliferative retinopathy.