title: [Ocular manifestations of syphilitic uveoretinitis in patients co-infected with human immunodeficiency virus].
abstract: OBJECTIVE
  To investigate the clinical manifestations of syphilitic uveoretinitis in patients co-infected with human immunodeficiency virus (HIV).
  
  
  METHODS
  Uveoretinitis patients presenting between January 2008 and December 2014 at Eye and ENT Hospital of Fudan University were collected. Patients were selected with positive serologic tests, including rapid plasma regain titer (RPR) > 1:8, treponema pallidum particle agglutination assay (TPPA) and human immunodeficiency virus (HIV). Other causes of uveoretinitis were excluded. Each patient underwent complete ophthalmologic examination including best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, ophthalmoscopy, applanation tonometry and B-scan ultrasonography. Fundus fluorescein angiography were obtained in each case except for patients whose fundus was blurred with dense vitritis. Optical coherence tomography (OCT) was performed in selected patients. Thorough physical examination was performed simultaneously.
  
  
  RESULTS
  Twenty six patients were included in this study including 24 male (92.3%) and 2 female (7.7%). The mean age at presentation was 39.3 ± 13.2 (range 20 to 63 years). RPR titres ranged from 1:32 to 1:512. There were 49 eyes altogether and ocular involvement was bilateral in 23 patients (88.5%) and unilateral in 3 patients (11.5%). Panuveitis was the most common ophthalmic presentation (n = 39, 79.6%). Only two eyes were anterior uveitis (4.1%) and 8 eyes were posterior uveitis (16.3%). Anterior chamber cells+++ and mild to severe vitreous opacities were observed. Sixteen eyes presented with neuroretinitis (32.7%), 27 eyes had vitritis (55.1%), 5 eyes had retinochoroiditis (10.2%), 5 eyes had optic neuritis (10.2%), 5 eyes had retinitis (10.2%) including 2 eyes with necrotizing retinitis (4.1%), 4 eyes had retinal vasculitis (8.2%). Two eyes (11.5%) presented with posterior placoid chorioretinitis (4.1%) and multifocal choroiditis (4.1%). Systemic manifestations were detected. Five patients had a history of skin rash (19.2%), five (19.2%) had genital ulcers, three (11.5%) had chancre, two (7.7%) suffered from headache, two (7.7%) had a fever, one (3.8%) had oral ulcers and one patient (3.8%) lost his hair.
  
  
  CONCLUSIONS
  The clinical features are protean and lack of specificity. The most common manifestations was neuroretinitis, ususlly with vitritis.
authors.affiliation: Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, China; Email: zhangrui6589@163.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Zhang
authors.forename: Jiang
authors.initials: J
authors.lastname: Qian
authors.forename: Zhujian
authors.initials: Z
authors.lastname: Wang
authors.forename: Yifei
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D002825:Chorioretinitis / Q000150:complications / Q000175:diagnosis; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D009887:Ophthalmoscopy; D009902:Optic Neuritis / Q000150:complications / Q000175:diagnosis; D031300:Retinal Vasculitis / Q000150:complications / Q000175:diagnosis; D012173:Retinitis / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D013587:Syphilis / Q000150:complications* / Q000175:diagnosis; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis; D014606:Uveitis, Anterior / Q000150:complications / Q000175:diagnosis; D015866:Uveitis, Posterior / Q000150:complications / Q000175:diagnosis; D014792:Visual Acuity