Clinical Features of Syphilis Patients with Ocular Symptoms as the Initial Manifestation

Figures & data

Table 1 Patients Background and Physiological Findings

No.	Sex	Age	Stage of Syphilis	Meningitis	Neurological Symptoms	HIV test	Dermatological Symptoms
1	Female	50	Tertiary	Positive	Vestibular symptom	Negative	Macular erythema at trunk and limbs
2	Male	63	Secondary	Positive	None	Negative	Erythema at left fifth digit
3	Female	51	Latent	Positive	None	Untested	None
4	Male	63	Secondary	Negative	None	Negative	Penile souring
5	Female	52	Secondary	Negative	None	Negative	Erythema at trunk
6	Female	51	Unknown	Untested	None	Untested	None
7	Male	52	Latent	Positive	None	Negative	None
8	Male	42	Latent	Positive	None	Negative	None
9	Male	53	Secondary	Positive	Headache	Negative	None
10	Female	55	Secondary	Positive	Headache	Negative	None
11	Female	57	Secondary	Positive	Headache	Negative	Erythema at forehand

Abbreviation: HIV, human immunodeficiency virus.

Table 2 Changes of Visual Accuracy Before and After Antiluetic Therapy

No.	Treatment Details	Days Treated (Days)	Visual Acuity Before Treatment	Visual Acuity After Treatment
1	Ceftriaxone 2 g/day	14	−0.1/−0.1	−0.1/−0.1
	Amoxicillin 2 g/day	10
	Doxycycline 200 mg/day	5
2	Penicillin G 18 MU/day	14	−0.1/0.7	−0.1/−0.1
	Amoxicillin 2.25 g/day
3	Amoxicillin 1.5 g/day	14	−0.1/−0.1	−0.1/−0.1
4	Ceftriaxone 2 g/day	14	1.8/−0.1	0.2/−0.1
	Doxycycline 200 mg/day
5	Penicillin G 24 MU/day	14	−0.1/0.5	−0.1/0.4
6	Treatment refusal	–	1.7/2.0	Unknown
7	Penicillin G 24 MU/day	14	0/0.2	−0.1/−0.1
8	Ceftriaxone 2 g/day	14	−0.1/−0.1	−0.1/−0.1
9	Penicillin G 24 MU/day	14	0/0.1	−0.1/−0.1
10	Penicillin G 24 MU/day	14	0/−0.1	−0.1/−0.1
11	Penicillin G 24 MU/day	14	0.1/0.3	0.2/−0.1

Table 3 Ocular Findings at the First Appointment

No.	Anterior Chamber Cells	Keratic Precipitate	Iris Nodule	Posterior Synechia	Vitreous Opacity	Exudative Vitreoretinopathy	Disc Edema	Macular Edema	Acute Syphilitic Posterior Placoid Chorioretinitis	Retinal Vasculitis
1	1+/1+	+/+	-/-	-/-	0/0	-/-	+/++	-/-	-/-	-/-
2	0/1+	-/-	-/-	-/-	0/1+	-/-	+/-	-/-	-/+	-/-
3	0/0	-/-	-/-	-/-	0/1+	-/-	-/+	-/-	-/-	-/-
4	0/0	-/-	-/-	-/-	1+/1+	+/+	-/-	-/-	+/-	-/-
5	0/3+	-/+++	-/+	-/+	0/0	-/-	-/-	-/-	-/-	-/-
6	1+/1+	-/-	-/-	-/-	0/1+	-/-	+/+	-/-	-/-	-/-
7	0/0	-/-	-/-	-/-	0/0	-/-	-/-	+/+	-/-	+/+
8	0/0	-/-	-/-	-/-	1+/1+	-/-	-/-	-/-	-/-	+/+
9	0/0	-/-	-/-	-/-	1+/1+	+/+	-/-	-/-	-/-	-/-
10	1+/0	+/-	-/-	-/-	1+/1+	+/+	+/-	-/-	-/-	-/-
11	0/0	-/-	-/-	-/-	1+/1+	+/+	-/-	-/-	-/-	-/-

Notes: 0: none 1+: faint 2+: moderate 3+: marked 4+: intense. -: none +: moderate ++: marked +++: intense.

Figure 1 Acute syphilitic posterior placoid chorioretinitis observed at the first appointment. (A) Right eye of a 63-year-old man. (B) Left eye of a 68-year-old man.