Abstract BACKGROUND: Syphilitic uveitis is re-emerging alongside the systemic infection. In July 2017, an international group of uveitis-specialised ophthalmologists formed the International Ocular Syphilis Study Group to define current practice patterns. METHODS: 103 Study Group members based in 35 countries completed a 25-item questionnaire focused on case load, clinical presentations, use and interpretation of investigations, treatment and clinical indicators of poor prognosis. RESULTS: Members managed a mean of 6.1 patients with syphilitic uveitis in clinics that averaged 707 annual cases of uveitis (0.9%); 53.2% reported increasing numbers over the past decade. Patients presented to more members (40.2%) during secondary syphilis. Uveitis was usually posterior (60.8%) or pan (22.5%); complications included optic neuropathy, macular oedema and posterior synechiae. All members diagnosed syphilitic uveitis using serological tests (simultaneous or sequential testing algorithms), and 97.0% routinely checked for HIV co-infection. Cerebrospinal fluid (CSF) analysis was ordered by 90.2% of members, and 92.7% took uveitis plus Venereal Disease Research Laboratory test (VDRL) or fluorescent treponemal antibody absorption test (FTA-ABS) to indicate neurosyphilis. Patients were commonly co-managed with infectious disease physicians, and treated with penicillin for at least 10-14 days, plus corticosteroid. Features predicting poor outcome included optic neuropathy (86.3%) and initial misdiagnosis (63.7%). Reasons for delayed diagnosis were often practitioner-related. 82.5% of members tested every patient they managed with uveitis for syphilis. CONCLUSION: This comprehensive report by an international group of uveitis-specialised ophthalmologists provides a current approach for the management of syphilitic uveitis.

Current ophthalmology practice patterns for syphilitic uveitis / Genevieve, F Oliver; Roy, M Stathis; João, M Furtado; Tiago, E Arantes; Peter, J McCluskey; Janet, M Matthews; Justine, R Smith; Accorinti, M; Adan, A; Agarwal, A; Alieldin, R; Allegri, P; Alvarez, C; Androudi, S; Arevalo, Jf; Aubin, Mj; Babu, K; Barisani-Asenbauer, T; Barron, Z; Basu, S; Biswas, J; Bodaghi, B; Bursztyn, M; Jose Capella, M; Caspers, L; Chee, Sp; Cimino, L; Colombero, D; Concha Del Rio, Le; Curi, All; Dacey, M; Das, D; Davis, J; Edwar, L; Errera, Mh; Finamor, Lp; Fonollosa, A; Fortin, E; Fraser-Bell, S; Funk, M; Garcia-Serrano, Jl; Garweg, J; Garza-Leon, M; George, A; Goldstein, D; Goto, H; Gottlieb, C; Guedes, M; Guex-Crosier, Y; Gurbaxani, A; Henry, C; Hooper, C; Hovland, T; Hwang, Ys; Invernizzi, A; Isa, H; Jodar-Marquez, M; Kansupada, K; Kawali, A; Kempen, Jh; Khairallah, M; Krag, S; Kuijpers, R; Laithwaite, J; Lee, St; Lefebvre, P; Lehoang, P; Lobo, Am; Mahendradas, P; Mccluskey, P; Mili-Boussen, I; Mochizuki, M; Moschos, M; Nascimento, H; Nguyen, J; Nguyen, Qd; O'Keefe, G; Oli Mohamed, S; Ozdal, P; Menendez Padron, Mi; Palestine, A; Paroli, Mp; Pavesio, C; Pichi, F; Pleyer, U; Przezdziecka-Dolyk, J; Rao, N; Rathinam, S; Ribeiro, M; Roy, M; Sabat, O P; Sandhu, Hs; Sittivarakul, W; Smith, J; Smith, W; Somkijrungroj, T; Sood, A; Suelves, A; Tay-Kearney, Ml; Teuchner, B; Thorne, J; Trittibach, P; Tugal-Tutkun, I; Unzueta-Medina, Ja; Santos Valadares, Ed; Van Os, L; Wells, J; Alvarez, By; Young, S; Zierhut, M.. - In: BRITISH JOURNAL OF OPHTHALMOLOGY. - ISSN 0007-1161. - 103:11(2019), pp. 1645-1649. [10.1136/bjophthalmol-2018-313207]

Current ophthalmology practice patterns for syphilitic uveitis

Accorinti M;Paroli MP;
2019

Abstract

Abstract BACKGROUND: Syphilitic uveitis is re-emerging alongside the systemic infection. In July 2017, an international group of uveitis-specialised ophthalmologists formed the International Ocular Syphilis Study Group to define current practice patterns. METHODS: 103 Study Group members based in 35 countries completed a 25-item questionnaire focused on case load, clinical presentations, use and interpretation of investigations, treatment and clinical indicators of poor prognosis. RESULTS: Members managed a mean of 6.1 patients with syphilitic uveitis in clinics that averaged 707 annual cases of uveitis (0.9%); 53.2% reported increasing numbers over the past decade. Patients presented to more members (40.2%) during secondary syphilis. Uveitis was usually posterior (60.8%) or pan (22.5%); complications included optic neuropathy, macular oedema and posterior synechiae. All members diagnosed syphilitic uveitis using serological tests (simultaneous or sequential testing algorithms), and 97.0% routinely checked for HIV co-infection. Cerebrospinal fluid (CSF) analysis was ordered by 90.2% of members, and 92.7% took uveitis plus Venereal Disease Research Laboratory test (VDRL) or fluorescent treponemal antibody absorption test (FTA-ABS) to indicate neurosyphilis. Patients were commonly co-managed with infectious disease physicians, and treated with penicillin for at least 10-14 days, plus corticosteroid. Features predicting poor outcome included optic neuropathy (86.3%) and initial misdiagnosis (63.7%). Reasons for delayed diagnosis were often practitioner-related. 82.5% of members tested every patient they managed with uveitis for syphilis. CONCLUSION: This comprehensive report by an international group of uveitis-specialised ophthalmologists provides a current approach for the management of syphilitic uveitis.
2019
eye; syphilis; uveitis; infection; inflammation
01 Pubblicazione su rivista::01a Articolo in rivista
Current ophthalmology practice patterns for syphilitic uveitis / Genevieve, F Oliver; Roy, M Stathis; João, M Furtado; Tiago, E Arantes; Peter, J McCluskey; Janet, M Matthews; Justine, R Smith; Accorinti, M; Adan, A; Agarwal, A; Alieldin, R; Allegri, P; Alvarez, C; Androudi, S; Arevalo, Jf; Aubin, Mj; Babu, K; Barisani-Asenbauer, T; Barron, Z; Basu, S; Biswas, J; Bodaghi, B; Bursztyn, M; Jose Capella, M; Caspers, L; Chee, Sp; Cimino, L; Colombero, D; Concha Del Rio, Le; Curi, All; Dacey, M; Das, D; Davis, J; Edwar, L; Errera, Mh; Finamor, Lp; Fonollosa, A; Fortin, E; Fraser-Bell, S; Funk, M; Garcia-Serrano, Jl; Garweg, J; Garza-Leon, M; George, A; Goldstein, D; Goto, H; Gottlieb, C; Guedes, M; Guex-Crosier, Y; Gurbaxani, A; Henry, C; Hooper, C; Hovland, T; Hwang, Ys; Invernizzi, A; Isa, H; Jodar-Marquez, M; Kansupada, K; Kawali, A; Kempen, Jh; Khairallah, M; Krag, S; Kuijpers, R; Laithwaite, J; Lee, St; Lefebvre, P; Lehoang, P; Lobo, Am; Mahendradas, P; Mccluskey, P; Mili-Boussen, I; Mochizuki, M; Moschos, M; Nascimento, H; Nguyen, J; Nguyen, Qd; O'Keefe, G; Oli Mohamed, S; Ozdal, P; Menendez Padron, Mi; Palestine, A; Paroli, Mp; Pavesio, C; Pichi, F; Pleyer, U; Przezdziecka-Dolyk, J; Rao, N; Rathinam, S; Ribeiro, M; Roy, M; Sabat, O P; Sandhu, Hs; Sittivarakul, W; Smith, J; Smith, W; Somkijrungroj, T; Sood, A; Suelves, A; Tay-Kearney, Ml; Teuchner, B; Thorne, J; Trittibach, P; Tugal-Tutkun, I; Unzueta-Medina, Ja; Santos Valadares, Ed; Van Os, L; Wells, J; Alvarez, By; Young, S; Zierhut, M.. - In: BRITISH JOURNAL OF OPHTHALMOLOGY. - ISSN 0007-1161. - 103:11(2019), pp. 1645-1649. [10.1136/bjophthalmol-2018-313207]
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