title: Fluorescein and indocyanine-green angiography in ocular syphilis: an exploratory study.
abstract: BACKGROUND
  Fluorescein (FA) and indocyanine-green angiography (ICGA) may offer valuable information concerning disease severity and prognosis in ocular syphilis. The aim of the present study is to describe angiographic patterns encountered in the context of ocular syphilis, and to explore the associations between specific angiographic manifestations and severity of disease presentation, as well as disease evolution after treatment.
  
  
  METHODS
  We performed a retrospective institutional study with the inclusion of 23 patients with ocular syphilis presenting to the uveitis clinic of the Jules-Gonin Eye Hospital in a 10-year period. FA and ICGA were performed following a standard protocol for posterior uveitis. Patterns of fluorescence were noted, and statistical associations between each angiographic pattern and any demographic, clinical, or laboratory parameter at baseline and after treatment were sought.
  
  
  RESULTS
  The presence of any dark dots in ICGA was significantly associated with anterior uveitis (p = 0.031). The presence of hot spots in ICGA was significantly associated with longer duration of symptoms prior to initial visit (p = 0.032) and with male gender (p = 0.012). Weak non-significant trends were found associating vascular staining in FA with anterior uveitis (p = 0.066), vitritis (p = 0.069), and younger age (p = 0.061), as well as disc hyperfluorescence in FA with seropositivity for HIV (p = 0.089) and macular edema in FA with longer disease duration (p = 0.061). The presence of any dark dots in ICGA exhibited a weak trend of association with anterior uveitis and/or vitritis (p = 0.079).
  
  
  CONCLUSIONS
  Out of the several associations identified implicating specific angiographic features, we underline the possible role of the presence of dark dots in ICGA for identifying active inflammation, and the role of hot spots in ICGA as markers of long-standing disease. Vascular staining in FA appears to be more common in patients with severe ocular inflammation with presence of anterior uveitis and/or vitritis.
authors.affiliation: Jules-Gonin Eye Hospital, University of Lausanne, Av. de France 15, CH-1004, Lausanne, Switzerland.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Balaskas
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.forename: Stefano
authors.initials: S
authors.lastname: Giulieri
authors.forename: Yan
authors.initials: Y
authors.lastname: Guex-Crosier
mesh_terms: D000328:Adult; D002443:Ceftriaxone / Q000627:therapeutic use; D004396:Coloring Agents; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013588:Syphilis Serodiagnosis; D014605:Uveitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D004396:Coloring Agents; D010406:Penicillins; D002443:Ceftriaxone; D007208:Indocyanine Green