Journal of Ophthalmic and Vision Research

ISSN: 2008-322X

The latest research in clinical ophthalmology and the science of vision.

The First Reported Case of Ocular Syphilis in an Iranian Patient

Published date: Nov 30 2023

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: Oct–Dec 2023, Volume 18, Issue 4

Pages: 452–457

DOI: 10.18502/jovr.v18i4.14559

Authors:

Sahba FekriOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Shahram Salehi-RadOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Hosein NouriHosein.Nouri.2018@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Shabnam TehraniInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Bita ShalbafanClinical Research Development Center of Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Seyed-Hossein AbtahiOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract:

Purpose: To report the first case of ocular syphilis in an Iranian patient and discuss its diagnostic challenges.
Case Report: A man in his mid-70s presented with progressive bilateral visual and auditory decline. He had previously lived in a Southeast Asian country for 10 years. Prior steroid therapies entailed no inflammation subsidence. His visual acuity at presentation was light perception OU. Funduscopic findings included severe vitritis, severe optic atrophy, diffuse retinal vascular occlusion, and diffuse retinal atrophy OU. Angiography demonstrated diffuse areas of retinal and choriocapillaris atrophy with no active choroiditis. Scaly cutaneous lesions were noted on his palms and soles – atypical findings of secondary syphilis. Serum analysis revealed an underlying syphilis infection. The cerebrospinal fluid sample was reactive to anti-syphilis antibodies, securing a neurosyphilis diagnosis. Two weeks of antibiotic therapy resulted in cutaneous lesions resolution and relative visual improvement despite extensive baseline retinal atrophic damage.
Conclusion: Ocular syphilis can mimic numerous ocular inflammatory scenarios. In cases of ocular inflammation that is unresponsive to steroids, reconsidering alternative diagnoses, especially infections with the highest clinical relevance, is necessary. We stress the importance of acquiring patients’ sexual history, regardless of cultural barriers and the rarity of the entity in some regions.

Keywords: Syphilis, Neurosyphilis, Bacterial Ocular Infection, Uveitis

References:

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