Author:
Rahman Effie Z.,Beck Kinley D.,Wong Robert W.,Sohn Jeong-Hyeon,Diaz-Rohena Roberto D.,Harper C. Armitage
Abstract
A 23-year-old man developed bilateral rhegmatogenous retinal detachments secondary to high-titer ocular syphilis. The patient's titer increased four-fold after completing a 14-day course of intravenous penicillin (IVP). He underwent bilateral pars plana vitrectomy with silicone oil fill in both eyes. In this article, the authors propose an updated treatment method for patients with advanced ocular syphilis that includes oral doxycycline for 30 days following 14 days of IVP to optimally minimize the patient's infectious burden. Following surgery and this new treatment regime, this patient's best-corrected visual acuity 10 weeks postoperatively measured 20/50 in the right eye and 20/30 in the left eye. This case highlights a rare but devastating complication of ocular syphilis. We suggest the addition of oral doxycycline to IVP for patients with syphilis titers ≥ 1:256, HIV co-infection, and presence of posterior retinitis.
[
Ophthalmic Surg Lasers Imaging Retina
2024;55:46–50.]
Reference17 articles.
1. CDC. Sexually Transmitted Disease Surveillance 2020. US Department of Health and Human Services, CDC; 2020. https://www.cdc.gov/std/statistics/2020/tables/1.htm
2. CDC. 2015 Sexually Transmitted Disease Treatment Guidelines. US Department of Health and Human Services, CDC; 2015. https://www.cdc.gov/std/tg2015/syphilis.htm
3. Fulminant proliferative vitreoretinopathy in syphilitic uveitis
4. Rhegmatogenous Retinal Detachment in Syphilitic Uveitis: A Case Series and Comprehensive Review of the Literature
5. A case of syphilitic interstitial pulmonary fibrosis;Jankovic S;Croat Med J,1998