title: A Case of Syphilitic Uveitis in Which Vitreous Surgery Was Useful for the Diagnosis and Treatment.
abstract: OBJECTIVE
  To report a case of atypical syphilitic uveitis complicated with retinal vasculitis, proliferative retinopathy, and vitreous hemorrhage in which vitreous surgery was useful for the diagnosis and treatment.
  
  
  METHODS
  A 38-year-old female was referred to our hospital after noticing visual disturbance in her right eye. Fundoscopy examination of that eye revealed retinal phlebitis accompanied by retinal hemorrhage and soft exudate, and remarkable exudative changes in the retinal vessels from the upper arcade to the macula region. After a blood examination, a serological test showed positive for syphilis; however, systemic findings were scarce. Syphilitic uveitis was suspected, so we administered treatment for syphilis, anticoagulant treatment for retinal vasculitis, steroids for intraocular inflammation, and photocoagulation for the retinal nonperfusion area. However, her visual acuity (VA) decreased to 30 cm/counting fingers due to vitreous hemorrhage resulting from fibrovascular membrane at the optic disc. Since the vitreous hemorrhage was insufficiently absorbed, vitreous surgery was performed to remove the hemorrhage and fibrovascular tissue. Following surgery, the uveitis and retinal vasculitis subsided, and her corrected VA improved to 0.3. Postoperative examination of a fixed quantity of collected vitreous fluid for syphilis showed aTreponema pallidumhemagglutination value of 5,120 times the normal amount, thus confirming the syphilitic uveitis diagnosis.
  
  
  CONCLUSIONS
  Our findings show that when observing patients with obstructive retinal vasculitis of unknown causes, syphilitic uveitis should be considered as a differential diagnosis, and that vitreous surgery is useful for the diagnosis and treatment of atypical syphilitic uveitis which has progressed to proliferative retinopathy.
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Katsumura
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Shoda
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Nanae
authors.initials: N
authors.lastname: Takai
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan; Takeda Eye Clinic, Osaka City, Japan.
authors.forename: Sayako
authors.initials: S
authors.lastname: Takeda
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan; Maruyama Eye Clinic, Takatsuki City, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan; Tada Eye Clinic, Ikeda City, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Tada
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tajiri
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Teruyo
authors.initials: T
authors.lastname: Kida
authors.affiliation: Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Ikeda
keywords: Proliferative retinopathy; Retinal vasculitis; Syphilitic uveitis; Vitreous hemorrhage; Vitreous surgery