Current ophthalmology practice patterns for syphilitic uveitis. Issue 11 (30th January 2019)

• Record Type: Journal Article
• Authors: Oliver, Genevieve F; Stathis, Roy M; Furtado, João M; Arantes, Tiago E; McCluskey, Peter J; Matthews, Janet M; Smith, Justine R
• Other Names: author non-byline.; Accorinti Massimo author non-byline.; Adan Alfredo author non-byline.; Agarwal Aniruddha author non-byline.; Alieldin Rowayda author non-byline.; Allegri Pia author non-byline.; Alvarez Carlos author non-byline.; Androudi Sofia author non-byline.; Arevalo J. Fernando author non-byline.; Aubin Marie-Josee author non-byline.; Babu Kalpana author non-byline.; Barisani-Asenbauer Talin author non-byline.; Barron Zuly author non-byline.; Basu Soumyava author non-byline.; Biswas Jyotirmay author non-byline.; Bodaghi Bahram author non-byline.; Bursztyn Marcelo author non-byline.; Jose Capella Maria author non-byline.; Caspers Laure author non-byline.; Chee Soon-Phaik author non-byline.; Cimino Luca author non-byline.; Colombero Daniel author non-byline.; Concha del Rio Luz Elena author non-byline.; Curi Andre L. L. author non-byline.; Dacey Mark author non-byline.; Das Dipankar author non-byline.; Davis Janet author non-byline.; Edwar Lukman author non-byline.; Errera Marie-Helene author non-byline.; Finamor Luciana Peixoto author non-byline.; Fonollosa Alex author non-byline.; Fortin Eric author non-byline.; Fraser-Bell Samantha author non-byline.; Funk Marion author non-byline.; Garcia-Serrano Jose Luis author non-byline.; Garweg Justus author non-byline.; Garza-Leon Manuel author non-byline.; George Amala author non-byline.; Goldstein Debra author non-byline.; Goto Hiroshi author non-byline.; Gottlieb Chloe author non-byline.; Guedes Marta author non-byline.; Guex-Crosier Yan author non-byline.; Gurbaxani Avinash author non-byline.; Henry Christopher author non-byline.; Hooper Claire author non-byline.; Hovland Tanja author non-byline.; Hwang Yih-Shiou author non-byline.; Invernizzi Alessandro author non-byline.; Isa Hazlita author non-byline.; Jodar-Marquez Margarita author non-byline.; Kansupada Kashyap author non-byline.; Kawali Ankush author non-byline.; Kempen John H. author non-byline.; Khairallah Moncef author non-byline.; Krag Susanne author non-byline.; Kuijpers Robert author non-byline.; Laithwaite Jenny author non-byline.; Lee Shelly T. author non-byline.; Lefebvre Pierre author non-byline.; LeHoang Phuc author non-byline.; Lobo Ann-Marie author non-byline.; Mahendradas Padmamalini author non-byline.; McCluskey Peter author non-byline.; Mili-Boussen Ilhem author non-byline.; Mochizuki Manabu author non-byline.; Moschos Marilita author non-byline.; Nascimento Heloisa author non-byline.; Nguyen John author non-byline.; Nguyen Quan Dong author non-byline.; O'Keefe Ghazala author non-byline.; Oli Mohamed Shelina author non-byline.; Ozdal Pinar author non-byline.; Menendez Padron Maria Ines author non-byline.; Palestine Alan author non-byline.; Paroli Maria Pia author non-byline.; Pavesio Carlos author non-byline.; Pichi Francesco author non-byline.; Pleyer Uwe author non-byline.; Przezdziecka-Dolyk Joanna author non-byline.; Rao Narsing author non-byline.; Rathinam Sivakumar author non-byline.; Ribeiro Miguel author non-byline.; Roy Mili author non-byline.; Sabat O Pablo author non-byline.; Sandhu Harpal S. author non-byline.; Sittivarakul Wantanee author non-byline.; Smith Justine author non-byline.; Smith Wendy author non-byline.; Somkijrungroj Thanapong author non-byline.; Sood Arjun author non-byline.; Suelves Ana author non-byline.; Tay-Kearney Mei-Ling author non-byline.; Teuchner Barbara author non-byline.; Thorne Jennifer author non-byline.; Trittibach Peter author non-byline.; Tugal-Tutkun Ilknur author non-byline.; Unzueta-Medina Jose Antonio author non-byline.; Santos Valadares Emiliana Dos author non-byline.; Van Os Luc author non-byline.; Wells Jane author non-byline.; Alvarez Bety Yanez author non-byline.; Young Stephanie author non-byline.; Zierhut Manfred author non-byline.;
• Is Part Of: British journal of ophthalmology. Volume 103:Issue 11(2019)
• Page Start: 1645
• Page End: 1649
• Publication Date: 2019-01-30
• Subjects: infection -- inflammation -- eye, syphilis, uveitis; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2018-313207
• Languages: English
• ISSNs: 0007-1161

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.