title: Non-human Immunodeficiency Virus-related Ocular Syphilis in a Korean Population: Clinical Manifestations and Treatment Outcomes.
abstract: OBJECTIVE
  To describe the clinical manifestations and treatment outcomes of ocular syphilis in patients without human immunodeficiency virus (HIV) infection.
  
  
  METHODS
  A total of 45 eyes from 39 patients with ocular syphilis confirmed by serologic tests were reviewed retrospectively. The included cases were all non-HIV-infected patients presenting with intraocular inflammation from 2002 to 2014 at Kyung Hee University Hospital. Medical records of 45 eyes were analyzed and included best-corrected visual acuity and ophthalmologic examination findings of the anterior and posterior segments to determine the focus of inflammation. Optical coherence tomography and fluorescein angiography findings as well as both medical and surgical management were also analyzed.
  
  
  RESULTS
  The mean patient age was 61.0 years (range, 37 to 89 years). Bilateral ocular involvement occurred in 6 patients (15.4%), and diagnoses at presentation were most frequently related to posterior uveitis (38%), followed by panuveitis (29%) and optic neuritis (11%). Isolated interstitial keratitis and intermediate uveitis were uncommon (4%, both). Twenty-eight eyes (62.2%) were treated with penicillin, and 11 eyes (24.4%) underwent surgical treatment. The mean baseline best corrected visual acuity was 0.79 ± 0.59 (mean ± standard deviation, logarithm of the minimum angle of resolution) and significantly improved to 0.60 ± 0.63 at the final follow-up after treatment (p= 0.019). Mean visual improvement was significantly greater in the penicillin-treated group (p= 0.001). Visual impairment at the final visit occurred in 11 eyes (24.4%). Among the visual impairment group, 10 eyes (90.1%) had posterior segment-involving uveitis.
  
  
  CONCLUSIONS
  Visual outcomes of treated, non-HIV-related ocular syphilis were favorable regardless of time to presentation. Posterior segment-involving uveitis at presentation was associated with poor visual outcome.
authors.affiliation: Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Yonguk
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Seung-Young
authors.initials: SY
authors.lastname: Yu
authors.affiliation: Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hyung Woo
authors.initials: HW
authors.lastname: Kwak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
keywords: Human immunodeficiency virus; Penicillins; Syphilis; Uveitis