The Therapy for Acute Acquired Syphilitic Uveitis
Hlaváčková K., Strmeň P., Krásnik V., Hasa J., Ferková S.
I. oftalmologická klinika FN a LFUK, Bratislava, prednosta prof. MUDr. P. Strmeň, CSc. |
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Summary:
Purpose: In retrospective study (analysis) to report the effectiveness of therapy
on anatomic and functional outcomes in patients with acute acquired syphilitic
uveitis.
Design: Retrospective case – control study.
Participants:3 patients (4eyes)withsymptomsofocularacute inflammationwhich
occurred in latent stage of syphilis are included in our study. In all patients uveitis
was the first clinical symptom of syphilis.
Methods: In all 3 patients the infection of acquired syphilis was diagnosed using
specific and non-specific tests for treponemal antibody. In 2 eyes we performed
diagnostic and therapeutic pars plana vitrectomy. The management of ocular
syphilis in all patients consisted ofmega units of aqueous penicillin intravenously
or intramusculary, in 2 patients we used the combination with steroids.
Results: In 2 eyes with perioperatively obtained material of vitreous (during pars
plana vitrectomy) specific treponemal antibody was detected using specific
(TPHA) test. In the third patient infection was verified serologically. The final visual acuity of all 4 eyes is better than or equal to 6/12. The visual acuity of one
exe is 6/6.
Conclusion: Uveitis and neuroretinitis may be the first symptom of acquired
syphilis in latent stage. Early antibiotic treatment significantly improves anatomical
reparation of infection and visual outcomes.
Key words:
pars plana vitrectomy, syphilis, uveitis, neurosyphilis, serum control
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