The ghost of the great imitator: prognostic factors for poor outcome in syphilitic uveitis View Full Text


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Article Info

DATE

2019-12

AUTHORS

Rafael de Pinho Queiroz, Daniele Viana Inês, Felipe Telöken Diligenti, Victor Haygert Schnor, Jacobo Melamed, Wesley Ribeiro Campos, Daniel Vítor Vasconcelos-Santos

ABSTRACT

BACKGROUND: Syphilitic uveitis is reemerging globally, may lead to any type of intraocular inflammation, and is potentially sight-threatening. We aim to characterize clinical features and prognostic factors in patients with syphilitic posterior uveitis. METHODS: Retrospective chart review at two tertiary university-based referral centers in Brazil. Clinical data, laboratory results, and treatment outcomes were analyzed. Statistical analysis was performed using Fisher's exact test for categorical variables and Mann-Whitney U test for continuous variables. RESULTS: Forty-four patients (81 eyes) were consecutively diagnosed with syphilitic posterior uveitis between March 2011 and April 2013.Thirty-one were male (70.5%) and the mean age was 43.8 years (range 15-81). HIV confection was disclosed in 12 patients (29.3%). The most prevalent finding was vitritis (85.2%), followed by retinal involvement (76.4%) and optic disc abnormalities (63.5%). After treatment, mean visual acuity improved from 1.2 (20/320) to 0.6 (20/80; median 20/30), but 19 eyes (23.5%) persisted with ≤ 1.0 (20/200). Factors associated with final visual acuity ≤ 1.0 despite therapy were prior use of systemic corticosteroids (p = 0.001), higher Venereal Disease Research Laboratory titers (p = 0.004), longer duration of symptoms (p = 0.024), and worse initial VA (p < 0.001). CONCLUSIONS: Syphilitic uveitis is reemerging. Delayed diagnosis and inadvertent use of systemic corticosteroids are potentially modifiable prognostic factors to be considered for possibly improving outcomes. More... »

PAGES

2

References to SciGraph publications

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  • 2005-09. Syphilitic uveitis in patients infected with human immunodeficiency virus in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12348-019-0169-8

    DOI

    http://dx.doi.org/10.1186/s12348-019-0169-8

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1111514269

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30659387


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        "description": "BACKGROUND: Syphilitic uveitis is reemerging globally, may lead to any type of intraocular inflammation, and is potentially sight-threatening. We aim to characterize clinical features and prognostic factors in patients with syphilitic posterior uveitis.\nMETHODS: Retrospective chart review at two tertiary university-based referral centers in Brazil. Clinical data, laboratory results, and treatment outcomes were analyzed. Statistical analysis was performed using Fisher's exact test for categorical variables and Mann-Whitney U test for continuous variables.\nRESULTS: Forty-four patients (81 eyes) were consecutively diagnosed with syphilitic posterior uveitis between March 2011 and April 2013.Thirty-one were male (70.5%) and the mean age was 43.8\u2009years (range 15-81). HIV confection was disclosed in 12 patients (29.3%). The most prevalent finding was vitritis (85.2%), followed by retinal involvement (76.4%) and optic disc abnormalities (63.5%). After treatment, mean visual acuity improved from 1.2 (20/320) to 0.6 (20/80; median 20/30), but 19 eyes (23.5%) persisted with \u2264\u20091.0 (20/200). Factors associated with final visual acuity \u2264\u20091.0 despite therapy were prior use of systemic corticosteroids (p\u00a0=\u20090.001), higher Venereal Disease Research Laboratory titers (p\u00a0=\u20090.004), longer duration of symptoms (p\u00a0=\u20090.024), and worse initial VA (p\u00a0<\u20090.001).\nCONCLUSIONS: Syphilitic uveitis is reemerging. Delayed diagnosis and inadvertent use of systemic corticosteroids are potentially modifiable prognostic factors to be considered for possibly improving outcomes.", 
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