title: Syphilitic uveitis and optic neuritis in Sydney, Australia.
abstract: OBJECTIVE
  To describe ocular syphilis presentations to a tertiary referral eye hospital over a 5-year period and to document HIV coinfection frequency.
  
  
  METHODS
  A retrospective chart review was conducted of consecutive ocular syphilis presentations to Sydney Eye Hospital from 2007 to 2012. Inclusion criteria were positive syphilis serology, ocular inflammation on clinical examination and appropriate syphilis treatment. Outcome measures were clinical features at presentation and best-corrected visual acuity (BCVA) at interval follow-up.
  
  
  RESULTS
  Thirty-seven eyes of 25 patients were included in the series. Patients were predominantly male (92.0%, p<0.05) with mean age 43.7±14.0 years. Eight (32.0%) patients had confirmed HIV coinfection, three newly diagnosed with HIV. Twelve (32.4%) eyes demonstrated anterior segment involvement with anterior uveitis. Twenty-five (67.6%) eyes demonstrated posterior segment involvement, including panuveitis, acute syphilitic posterior placoid chorioretinitis, retinitis, necrotising retinitis, punctate retinitis and optic neuritis. There was a significant improvement in BCVA for involved eyes (p<0.05) at 1 month and 2-3 months follow-up.
  
  
  CONCLUSIONS
  The clinical findings of 37 eyes with ocular syphilis demonstrated a broad spectrum of clinical manifestations. Rates of HIV coinfection were high, with patients exhibiting both anterior and posterior segment inflammation. Visual outcome improved following syphilis treatment.
authors: Save Sight Institute, Discipline of Ophthalmology, Sydney Eye Hospital Campus, The University of Sydney, Sydney, Australia.
authors: Luke C
authors: LC
authors: Northey
authors: Save Sight Institute, Discipline of Ophthalmology, Sydney Eye Hospital Campus, The University of Sydney, Sydney, Australia.
authors: Simon E
authors: SE
authors: Skalicky
authors: Save Sight Institute, Discipline of Ophthalmology, Sydney Eye Hospital Campus, The University of Sydney, Sydney, Australia.
authors: Avinash
authors: A
authors: Gurbaxani
authors: Save Sight Institute, Discipline of Ophthalmology, Sydney Eye Hospital Campus, The University of Sydney, Sydney, Australia.
authors: Peter J
authors: PJ
authors: McCluskey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia; D002825:Chorioretinitis / Q000209:etiology / Q000382:microbiology; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000150:complications; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D009902:Optic Neuritis / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D013587:Syphilis / Q000150:complications* / Q000188:drug therapy; D014605:Uveitis / Q000209:etiology* / Q000382:microbiology; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infection; Retina