Syphilitic retinitis and uveitis in HIV‐positive adults

Abstract

This case series reinforces the importance of considering syphilis in the differential diagnosis of many ocular presentations, but in particular retinitis. Retinitis appears to be the predominant presentation in HIV-infected individuals, suggesting that HIV infection may somehow modulate the disease.

Posterior syphilitic uveitis: clinical characteristics, co-infection with HIV, response to treatment

“…Tran et al [15] found 7 of 19 eyes (39%) in HIV-positive patients with posterior uveitis to have necrotizing retinitis. Some studies report a lower rate [6], whereas a recent series [18] reports 6 of 6 HIV positive patients with retinitis. It is striking that the majority of cases of syphilitic retinitis, and necrotizing retinitis in particular, are reported in HIV-positive patients [6,15,26,28,30] suggesting a more severe presentation of syphilitic uveitis in the HIV population [31].…”

“…Though previously thought to be uncommon, recent studies [15,18] demonstrate increasing rates of syphilitic retinitis. Tran et al [15] found 7 of 19 eyes (39%) in HIV-positive patients with posterior uveitis to have necrotizing retinitis.…”

“…Several authors have published series on ocular syphilis [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Most studies include patients with anterior and posterior uveitis, and few look at posterior uveitis specifically [4,5,14].…”

Practical diagnostic approach to uveitis

“…Multifocal choroiditis is caused by many etiologies including sarcoidosis, VKH disease, sympathetic ophthalmia, histoplasmosis, birdshot chorioretinopathy, serpiginous choroidopathy, multiple white-dot syndromes and nematode-associated disease [44,[88][89][90]. A discussion of the whitedot syndromes is beyond the scope of this paper; however, the diagnoses are made based on clinical history, ocular examination, clinical course, characteristic findings on ocular imaging and in some cases electrophysiologic testing.…”

Atypical presentation of ocular syphilis in an individual with AIDS

“…[1], [2] , Sandra Dias [3] and Fabiana Gonzaga [1] [1]. Ocular complications are common in acquired immunodefi ciency syndrome (AIDS) and occur in 50-75% of patients throughout the course of their illness.…”