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Fekri S, Salehi-Rad S, Nouri H, Tehrani S, Shalbafan B, Abtahi S-H. The First Reported Case of Ocular Syphilis in an Iranian Patient. JOVR [Internet]. 2023Nov.30 [cited 2024May14];18(4):452–457. Available from: https://knepublishing.com/index.php/JOVR/article/view/14559

https://doi.org/10.18502/jovr.v18i4.14559

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authors

  • Sahba Fekri

    Sahba Fekri

    Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Shahram Salehi-Rad

    Shahram Salehi-Rad

    Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Hosein Nouri

    Hosein Nouri

    Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Shabnam Tehrani

    Shabnam Tehrani

    Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Bita Shalbafan

    Bita Shalbafan

    Clinical Research Development Center of Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Seyed-Hossein Abtahi

    Seyed-Hossein Abtahi

    Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Published Date

  • Nov 30, 2023
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

The First Reported Case of Ocular Syphilis in an Iranian Patient

Journal of Ophthalmic and Vision Research (JOVR) / Oct–Dec 2023, Volume 18, Issue 4 / Pages 452–457

Abstract

Purpose: To report the first case of ocular syphilis in an Iranian patient and discuss its diagnostic challenges.
Case Report: A man in his mid-70s presented with progressive bilateral visual and auditory decline. He had previously lived in a Southeast Asian country for 10 years. Prior steroid therapies entailed no inflammation subsidence. His visual acuity at presentation was light perception OU. Funduscopic findings included severe vitritis, severe optic atrophy, diffuse retinal vascular occlusion, and diffuse retinal atrophy OU. Angiography demonstrated diffuse areas of retinal and choriocapillaris atrophy with no active choroiditis. Scaly cutaneous lesions were noted on his palms and soles – atypical findings of secondary syphilis. Serum analysis revealed an underlying syphilis infection. The cerebrospinal fluid sample was reactive to anti-syphilis antibodies, securing a neurosyphilis diagnosis. Two weeks of antibiotic therapy resulted in cutaneous lesions resolution and relative visual improvement despite extensive baseline retinal atrophic damage.
Conclusion: Ocular syphilis can mimic numerous ocular inflammatory scenarios. In cases of ocular inflammation that is unresponsive to steroids, reconsidering alternative diagnoses, especially infections with the highest clinical relevance, is necessary. We stress the importance of acquiring patients’ sexual history, regardless of cultural barriers and the rarity of the entity in some regions.

Keywords:

Syphilis, Neurosyphilis, Bacterial Ocular Infection, Uveitis

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