| Objective To summarize the clinical data of syphilitic uveitis and syphilitic scleritis in the department of uveitis and ocular immune of our hospital.To analysis the relative factors of syphilitic eye diseases in epidemiology,clinical features,diagnosis,treatment and prognosis.Method Retrospective Analysis We retrospectively analyzed the clinical data of 21 patients(33 eyes)diagnosed with syphilitic uveitis and 7 patients(7 eyes)with syphilitic scleritis from March 2011 to March 2016 in northern China.All patients with syphilitic ophthalmopathy were diagnosed by clinical and serological tests.In all cases,the best corrected visual acuity(BCVA),the treatment of syphilis,and the prognosis of visual acuity were analyzed.The related factors influencing disease development,treatment and visual prognosis were analyzed.Univariate analysis was used to analyze the correlation between systemic immunosuppressants and final BCVA prior to the start of antibiotic treatment.The correlation between age,duration of disease and initial BCVA and final BCVA was analyzed by linear correlation analysis.Multiple linear regression was used to analyze the effect of all variables on prognosis.Results: 28 cases(33 eyes)were diagnosed with ocular syphilis.Among these patients,21 patients presented with syphilitic uveitis and 7 patients presented with syphilitic scleritis.Both RPR and TPPA were positive in 20 patients.One patient had a negative RPR test,but a positive TPPA.Syphilis was first diagnosed in 18 patients during their first visit to our department.Bilateral disease was found in 11 patients,unilateral disease in 7 patients.The average age of the patients was(48.1 ± 11.7)years,and 8 patients(38.1%)were male while 13 patients(61.9%)were female.Blurring of vision was the most common complaint in 31 eyes(93.9%),followed by floaters(14 eyes,42.4%),redness(11 eyes,33.3%),pain(7 eyes,21.2%),and photopsia(7 eyes,21.2%).The duration between the initial symptom and the first presentation 21 patients ranged from 6 days to 24 months.The duration of 10 patients was longer than 6 months,while only two patients was less than 1 month.Posterior uveitis were found in 19 eyes(57.6%),panuveitis in13 eyes(39.4%),intermediate in one eye(3.0%).Posterior uveitis mainly manifested as diffuse chorioretinitis,other ocular manifestations iclude neuroretinitis,papillitis,retinitis,posterior placoid Chorioretinitis.Seven patients presented with syphilitic scleritis,among whom 5 patients were male(71.4%),2 patients were female(28.6%).All patients were first diagnosed as syphilis.All patients were unilateral.The average age was(46.6 + 9.90)years.All patients(100%)complained eye redness and eye pain,one patient had aggravated nocturnal pain,and one patient suffered from visual acuity decrease.The duration of the disease of the patients ranged from 7 days to 24 months,which of 5 patients was longer than one month,while only that of 2 patients was less than one month.The most common scleritis type is nodular anterior scleritis,followed by episcleritis and diffuse anterior episcleritis,and one patient presented with diffuse episcleritis combined with syphilitic posterior placoid chorioretinitis(SPPC).Univariate analyses showed that systemic immunosuppressive therapy prior to the start of antibiotic treatment was associated with worse BCVA outcomes.The duration of the disease and the age negatively correlated with the final BCVA,while the initial BCVA positively correlated with the final BCVA.However,using multivariate linearregression,we found that only a low BCVA(P = 0.022)and a delay of syphilis treatment(P <0.001)were associated with a significantly worse visual outcome.Conclusion: In our country,the incidence of syphilis infection increased.Ocular syphilis can be the first symptom of syphilis infection without systemic manifestations.Clinically,ocular and systemic manifestations,serological examination and syphilis therapeutic effects can help us to diagnosis and treat the patients early,thereby to get satisfied prognosis. |
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