Costa Celso, Machado Telma, Zhu André, Sá Rosa, Rodrigues Fernando, Fonseca Pedro, Gonçalo João, Torres Carolina, Fonseca Cristina
Department of Ophthalmology, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Public Health Department, Unidade Local de Saúde de Coimbra, Coimbra, Portugal.
Ocul Immunol Inflamm. 2025 Apr;33(3):385-395. doi: 10.1080/09273948.2024.2413902. Epub 2024 Oct 10.
To estimate the number of ocular syphilis (OS) cases diagnosed in a tertiary care centre in Portugal, correlate with increasing syphilis diagnoses and characterize the OS population.
Retrospective, observational, single-center study that included patients diagnosed with OS between 2015 and 2023 at the local health unit of Coimbra. Demographic data were collected, and a complete ophthalmological examination was performed with multimodal imaging acquisition. Data on syphilis reports from the National System of Epidemiologic Surveillance were correlated with OS data.
Fifty-four patients with OS were observed; mean age was 54.17 ± 14.46 years, 38 (70.37%) were male and 18 (47.37%) men who have sex with men. The proportion of OS in syphilis patients per year ranged from 0% to 10.34%. One-quarter were co-infected with HIV. Forty-nine patients (91.84%) complained of decreased visual acuity on presentation. Twenty-two (40.74%) had systemic findings (mostly skin rash). Two-thirds had bilateral disease and half presented with anterior segment involvement. Eighty-five percent had posterior segment involvement, mostly placoid chorioretinitis. Forty-one percent had optic nerve involvement. All patients were admitted and underwent 2-week treatment with intravenous penicillin. Visual acuity improved from logMAR 0.70 to logMAR 0.26 ( < 0.001).
Ocular syphilis is a heterogeneous disease with a wide range of presentations. The incidence is on the rise and therefore OS must be considered in every patient with anterior and posterior uveitis, panuveitis and optic neuritis, with or without systemic manifestations.
评估葡萄牙一家三级医疗中心诊断的眼梅毒（OS）病例数量，与梅毒诊断增加情况进行关联，并对OS患者群体进行特征描述。
一项回顾性、观察性单中心研究，纳入2015年至2023年在科英布拉当地卫生单位诊断为OS的患者。收集人口统计学数据，并进行全面的眼科检查及多模态成像采集。将国家流行病学监测系统的梅毒报告数据与OS数据进行关联。
观察到54例OS患者；平均年龄为54.17±14.46岁，38例（70.37%）为男性，18例（47.37%）为男男性行为者。每年梅毒患者中OS的比例在0%至10.34%之间。四分之一的患者合并感染HIV。49例患者（91.84%）就诊时主诉视力下降。22例（40.74%）有全身表现（主要为皮疹）。三分之二的患者为双侧疾病，一半患者有前段受累。85%的患者有后段受累，主要为地图状脉络膜视网膜炎。41%的患者有视神经受累。所有患者均入院并接受了为期2周的静脉青霉素治疗。视力从logMAR 0.70提高到logMAR 0.26（<0.001）。
眼梅毒是一种表现多样的异质性疾病。发病率呈上升趋势，因此对于每一位患有前、后葡萄膜炎、全葡萄膜炎和视神经炎的患者，无论有无全身表现，都必须考虑眼梅毒。
