Pereira Samuel Montenegro, Araújo Maria Alix Leite, Lima Rian Vilar, Nobre Rivianny Arrais, da Silva Ana Patrícia Alves, Braga Rocha Ana Fátima, Jorge Rodrigo, Broutet Nathalie
Center for Health Sciences, University of Fortaleza, Ceará, Brazil.
Maternal and Child Health Department, Federal Ceara University, Ceará, Brazil.
Int J Retina Vitreous. 2025 Jun 10;11(1):63. doi: 10.1186/s40942-025-00689-y.
Congenital syphilis (CS) is associated with interstitial keratitis, chorioretinitis, uveitis, and optic atrophy mainly in inadequately treated patients. We conducted a retrospective cohort analysis evaluating ocular findings in children born in 2015 with CS treated with ceftriaxone at the time of delivery during the period of penicillin shortage in a city located at Northeast of Brazil and compared them with those adequately treated.
469 children were reported with CS at birth during the penicillin shortage period and 171 were actively searched and invited to an ophthalmological assessment and retrospective analysis of their information recorded in the medical records of the municipality's health services.
A total of 68 children came to the assessment, median age 8 years of age (range 7-8 years), 48 were treated with penicillin (70.5%) and 20 with ceftriaxone (29.5%). There were no significant differences in demographic or perinatal characteristics between the groups. The majority of children had a completely normal ophthalmological examination (67.6%). Regarding findings that are more associated with CS, one child in ceftriaxone group (5.0%) had optic atrophy in one eye and one in the penicillin group (2.9%) had glaucomatous optic disc changes. No interstitial keratitis was found. There was no significant association between the child's treatment and the prevalence of ophthalmologic findings (p = 0.663). There was also no association between the medication and a current reactive VDRL (p = 1.000).
After an 8-year follow-up, no statistically significant difference was observed in the incidence of ophthalmologic manifestations among individuals treated for CS with either penicillin or ceftriaxone. These findings suggest that ceftriaxone may serve as an effective alternative for the prevention of CS and its associated ocular complications.
先天性梅毒（CS）主要与间质性角膜炎、脉络膜视网膜炎、葡萄膜炎和视神经萎缩有关，主要发生在治疗不充分的患者中。我们进行了一项回顾性队列分析，评估2015年出生的患有CS的儿童在巴西东北部一个城市青霉素短缺期间分娩时接受头孢曲松治疗后的眼部检查结果，并将他们与接受充分治疗的儿童进行比较。
在青霉素短缺期间，有469名儿童出生时被报告患有CS，其中171名被积极寻找并邀请进行眼科评估，并对他们在市卫生服务机构医疗记录中记录的信息进行回顾性分析。
共有68名儿童前来评估，中位年龄8岁（范围7 - 8岁），48名接受青霉素治疗（70.5%），20名接受头孢曲松治疗（29.5%）。两组在人口统计学或围产期特征方面无显著差异。大多数儿童的眼科检查完全正常（67.6%）。关于与CS更相关的检查结果，头孢曲松组有1名儿童（5.0%）一只眼睛出现视神经萎缩，青霉素组有1名儿童（2.9%）出现青光眼性视盘改变。未发现间质性角膜炎。儿童的治疗与眼科检查结果的患病率之间无显著关联（p = 0.663）。药物与当前反应性VDRL之间也无关联（p = 1.000）。
经过8年的随访，用青霉素或头孢曲松治疗CS的个体中，眼科表现的发生率在统计学上无显著差异。这些发现表明，头孢曲松可能是预防CS及其相关眼部并发症的有效替代药物。
