Optical Coherence Tomography Findings in Ocular Syphilis Involving the Posterior Segment of the Eye

ABSTRACT

Purpose

To analyse posterior segment optical coherence tomography (OCT) findings in ocular syphilis.

Methods

Medical records of 54 patients presenting consecutively with syphilitic uveitis were reviewed. Vitreous, retina and choroid (one eye/patient) were assessed by spectral-domain OCT on presentation (54 eyes) and after treatment (31 eyes). Improvement in signs and associations between presenting signs and final best corrected visual acuity (BCVA) were determined by McNemar’s and Fisher’s exact tests.

Results

Early inner retinal OCT findings included hyperreflective dots (n = 49, 91%), tongue-like projections (n = 44, 81%) and large rounded spots (n = 41, 76%). Common outer retinal findings included thickening, irregularity, elevations and/or detachment of retinal pigment epithelium (n = 46, 85%), and disruption or loss of the ellipsoid zone (n = 33, 61%). Most outer retinal changes resolved with treatment (p < .05), and common presenting signs were not associated with poor final BCVA (p > .05).

Conclusion

OCT findings have diagnostic value in ocular syphilis, but do not predict prognosis.

KEYWORDS:

• Syphilis
• eye
• retina
• uveitis
• optical coherence tomography

Acknowledgments

The authors wish to thank Mrs. Janet Matthews for administrative support in the preparation of this manuscript.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported in part by grants from Fundação de Apoio ao Ensino, Pesquisa e Assistência (JMF) and the Australian Research Council (FT130101648 to JRS).