title: Ocular syphilis: an alarming infectious eye disease.
abstract: BACKGROUND
  To describe the clinical manifestations and ancillary examination outcomes of ocular syphilis in Southeast China.
  
  
  METHODS
  This is a retrospective, nonrandom case study. Demographic information, serum and cerebrospinal fluid (CSF) test results, and findings of fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and spectral domain optical coherence tomography (SD-OCT) were analyzed.
  
  
  RESULTS
  The study examined 21 eyes of 13 patients (average age 50.3 ± 5.9 (range 37-61) years). HIV co-infection was found in one patient. The most common manifestation was chorioretinitis (52.4%). Disc hyperfluorescence (66.7%) and persistent dark spots (91.7%) were the most common findings on FFA and ICGA, respectively. The inner segment/outer segment junction (IS/OS) loss was the most frequent manifestation (86.7%). Among the six patients with confirmed neurosyphilis, the average CSF protein level was 528.8 ± 327.1 mg/L. Visual acuity (VA) was improved in 8 of 13 eyes (61.5%) after treatment.
  
  
  CONCLUSIONS
  The manifestations of ocular syphilis can mimic any eye disease. Chorioretinitis was the most common finding in this case series. "Leopard spots" was the characteristic manifestation on FFA. IS/OS loss was the most common finding in patients with posterior uveitis on SD-OCT. Lumbar puncture can contribute to the diagnosis of neurosyphilis. Treatment for ocular syphilis was effective in these patients.
authors.affiliation: Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang, P. R. China.
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang, P. R. China.
authors.forename: Liguo
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Ophthalmology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine Hangzhou, Zhejiang, P. R. China.
authors.forename: Yumin
authors.initials: Y
authors.lastname: Li
keywords: CSF; Chorioretinitis; FFA; ICGA; SD-OCT; neurosyphilis; ocular syphilis; syphilis