Ocular Syphilis: A Retrospective Alberta Case Series

Track:
Uveitis
What:
Paper Presentation | Présentation d'article
When:
10:50 AM, Friday 10 Jun 2022 (10 minutes)
Where:
How:

Authors: Tyler J. Henry Gurkaran S. Sarohia, Natalia Figueiredo, Natalie Dougherty, Matthew Tennant, Alejandra Ugarte-Torres, Hoi Tai Fung, R. Geoff Williams, Michael Fielden, Anna Ells, Patrick Mitchell, Mark Greve, Rizwan Somani, Chad Baker, Brad Hinz, Mark Seamone, David Ehmann, Amin Kherani.

Author Disclosure Block: T.J. Henry: None. G.S. Sarohia: None. N. Figueiredo: None. N. Dougherty: None. M. Tennant: None. A. Ugarte-Torres: None. H. Fung: None. R. Williams: Membership on advisory boards or speakers bureaus; Name of for-profit or not-for-profit organization(s); Bayer, Novartis, Roche. Membership on advisory boards or speakers’ bureaus; Description of relationship(s); Advisory Panel.

Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Bayer, Allergan, Novartis, Roche, Chengdu Kanghong Biotechnology. Funded grants or clinical trials; Description of relationship(s); Investigator. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for-profit organization(s); ArticDx. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Shareholder. M. Fielden: Membership on advisory boards or speakers’ bureaus; Name of for-profit or not-for-profit organization(s); Bayer, Novartis. Membership on advisory boards or speakers’ bureaus; Description of relationship(s); Advisory Board. Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Alexion, Ophthea, Roche, Bayer, Iveric, Novartis, Chengdu Kanghong Biotechnology. Funded grants or clinical trials; Description of relationship(s); Investigator. A. Ells: None. P. Mitchell: None. M. Greve: None. R. Somani: None. C. Baker: None. B. Hinz: None. M. Seamone: None. D. Ehmann: None. A. Kherani: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); Novartis, Roche, Bayer, Alcon. Any direct financial payments including receipt of honoraria; Description of relationship(s); Educational. Membership on advisory boards or speakers’ bureaus; Name of for-profit or not-for-profit organization(s); Abbvie, Alcon, Bayer, B+L, Novartis.

Membership on advisory boards or speakers’ bureaus; Description of relationship(s); Advisory Panel. Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Abbvie, Allergan, Alcon, Bayer, Novartis, F. Hoffmann - La Roche, Genetch, Ophthotech, Chengdu Kanghong Biotechnology, Regeneron. Funded grants or clinical trials; Description of relationship(s); Investigator. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Name of for-profit or not-for- profit organization(s); MD Collaborate, Office of Surgical Education, University of Calgary. All other investments or relationships that could be seen by a reasonable, well-informed participant as having the potential to influence the content of the educational activity; Description of relationship(s); Shareholder, Fellowship Director.

Abstract Body:

Purpose: To describe the demographics, clinical manifestations, visual outcomes and management of ocular syphilis cases in Alberta, Canada.

Study Design: A retrospective multi-centre, multi-physician case review.

Methods: An electronic health record chart review of 29 patients from 3 group practices and 12 Alberta based retinal physicians from 2014 to 2021.

Results: We identified 29 patients (18 male, 11 female) with a mean age of 51 years (24-87) with confirmed syphilis serology. All patients presented with inflammatory manifestations of syphilis including anterior, intermediate, posterior and panuveitis. Ten presented with unilateral uveitis and 19 with bilateral(total of 48 eyes). A total of 79% patients had no prior syphilis diagnosis and 10% were HIV positive. The predominant symptoms included decreased vision (79%), floaters (48%), flashes (21%), ocular pain (21%) and red eye (10%). Only 34% reported systemic symptoms which included headaches (24%) or rash (10%). Multimodal retinal and systemic imaging were used in each case and will be highlighted. Mean time to diagnosis was 51 days (0 to 378). Best corrected visual acuity (mean LogMAR) for initial, final and change were 0.46 (-1.54 to 2.3), 0.34 (0 to 2.3) and -0.12 (-1.54 to 1.90) respectively, with an overall improvement in vision post treatment (p = 0.187). Patients were recommended to undergo treatment with neuro-syphilis protocol.

Conclusions: Ocular Syphilis can be difficult to diagnosis. Early identification and management are crucial to sight and globe preservation.

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