Clinical Manifestations of Ocular Syphilis Combined with Neurosyphilis.

Cho, Yong Wun; Kim, Che Ron; Han, Yong Seop; Chung, In Young; Park, Jong Moon

doi:2014.55.4.602

J Korean Ophthalmol Soc > Volume 55(4); 2014 > Article

Original Article

Journal of the Korean Ophthalmological Society 2014;55(4):602-607.
DOI: https://doi.org/10.3341/jkos.2014.55.4.602 Published online April 15, 2014.

Clinical Manifestations of Ocular Syphilis Combined with Neurosyphilis.

Yong Wun Cho, Che Ron Kim, Yong Seop Han, In Young Chung, Jong Moon Park

¹Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea. parkjm@gnu.ac.kr
²Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea.

신경매독과 연관되어 발생한 안매독의 임상 양상

조용운¹⋅김체론¹⋅한용섭^1,2⋅정인영^1,2⋅박종문^1,2

Department of Ophthalmology, Gyeongsang National University School of Medicine¹, Jinju, Korea
Gyeongsang Institute of Health Science, Gyeongsang National University², Jinju, Korea

Abstract

PURPOSE
To report the manifestation of ocular syphilis combined with neurosyphilis in patients who present with uveitis clinically and are diagnosed initially by an ophthalmologist. METHODS: This study is a retrospective, clinical investigation of seven male patients with ocular syphilis from a single tertiary center between 2009 and 2012. RESULTS: The average age of the patients at onset was 44.4 years (range, 33-71 years). Posterior segment involvement was found in all patients. Two patients had papillitis. In serologic testing, all patients had positive responses to Venereal Disease Research Laboratory (VDRL), fluorescent treponemal antibody-absorption test (FTA-ABS) and Treponema pallidum hemagglutination (TPHA). In fluorescein angiography (FAG), retinal vascular and disc leakage was the most common finding. Cerebrospinal fluid (CSF) analysis was performed for six patients and demonstrated positive CSF FTA-ABS and CSF TPHA tests in all patients. CSF VDRL was reactive in 2 patients (33.3%). CONCLUSIONS: All patients with ocular syphilis were diagnosed with neurosyphilis based on the analysis of CSF with FTA-ABS and TPHA. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis.

Key Words: CSF analysis;Neurosyphilis;Ocular syphilis