A descriptive study of syphilitic uveitis in patients treated at tertiary hospitals in Johannesburg
Résumé
Background: Syphilitic uveitis is a ‘great mimicker’ with a myriad of manifestations resembling other forms of inflammation in the eye. A large percentage of patients with syphilitic uveitis in South Africa have HIV co-infection and their clinical features and serological results may be confounded by the presence of HIV. Aim: This study aimed to describe the clinical features of patients treated for syphilitic uveitis at two tertiary hospitals in Johannesburg. Setting: The study was conducted at the ophthalmology departments of two tertiary hospitals in Johannesburg. Methods: A retrospective descriptive case series of patients admitted for treatment of syphilitic uveitis at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Hospitals. Results: From 01 January 2015 to 30 June 2020, 25 patients (44 eyes) were admitted for syphilitic uveitis treatment. Vitritis was the most common sign in 54.5% of the patients (n = 24 eyes) and 23 of these eyes were of HIV positive patients. Anterior chamber cells were in 43.1% of the patients (n = 19 eyes), posterior synechiae in 36.3% (n = 16 eyes), optic disc swelling in 31.8% (n = 14 eyes), pigmentary retinopathy in 18.1% (n = 8 eyes) and ciliary injection in 18.1% (n = 8 eyes). Optic disc swelling was observed in 57.1% (n = 4 eyes) of HIV negative patients. There was an improvement in visual acuity (VA) in 64.3% of eyes (n = 27) and no change in VA in 35.7% (n = 15) of eyes. No deterioration in post-treatment VA was documented. Conclusion: Majority of the patients admitted for syphilitic uveitis had posterior segment signs, which should prompt a diagnosis of syphilis. The treatment of syphilitic uveitis leads to an improvement in VA. Contribution: This work contributes to our understanding of syphilitic uveitis presentation in South African hospitals.
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