Ocular syphilis unmasked following intravitreal triamcinolone injection.
OBJECTIVE
To report intravitreal triamcinolone (IVTA)-induced unmasking of ocular syphilis.


METHODS
Two case reports.


METHODS
A homosexual, diabetic male with macular edema treated with bilateral IVTA and a male with bilateral panuveitis and macular edema who underwent vitrectomy and IVTA. Both developed occlusive retinal vasculitis and panuveitis postinjection. Syphilis serology was positive although both denied previous symptoms.


RESULTS
Intramuscular penicillin lead to resolution of inflammation but both sustained severe loss of vision. Cause-and-effect relationship demonstrated between IVTA and reactivation of syphilis.


CONCLUSIONS
Intravitreal corticosteroid can modulate the immune response to intraocular syphilis; vigilance is required, particularly in high-risk patients.
Mushtaq
Bushra
B
Birmingham and Midland Eye Centre, Birmingham, UK.
Gupta
Rajen
R
Elsherbiny
Samer
S
Murray
Philip I
PI
D000328:Adult; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000276:immunology; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015864:Panuveitis / Q000188:drug therapy*; D012008:Recurrence; D031300:Retinal Vasculitis / Q000175:diagnosis* / Q000276:immunology; D013587:Syphilis / Q000175:diagnosis* / Q000276:immunology; D013588:Syphilis Serodiagnosis; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide