1. Current ophthalmology practice patterns for syphilitic uveitis
- Author
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Genevieve, F Oliver, Roy, M Stathis, João, M Furtado, Tiago, E Arantes, Peter, J McCluskey, Janet, M Matthews, Justine, R Smith, Accorinti, M, Adan, A, Agarwal, A, Alieldin, R, Allegri, P, Alvarez, C, Androudi, S, Arevalo, Jf, Aubin, Mj, Babu, K, Barisani-Asenbauer, T, Barron, Z, Basu, S, Biswas, J, Bodaghi, B, Bursztyn, M, Jose Capella, M, Caspers, L, Chee, Sp, Cimino, L, Colombero, D, Concha Del Rio LE, Curi, All, Dacey, M, Das, D, Davis, J, Edwar, L, Errera, Mh, Finamor, Lp, Fonollosa, A, Fortin, E, Fraser-Bell, S, Funk, M, Garcia-Serrano, Jl, Garweg, J, Garza-Leon, M, George, A, Goldstein, D, Goto, H, Gottlieb, C, Guedes, M, Guex-Crosier, Y, Gurbaxani, A, Henry, C, Hooper, C, Hovland, T, Hwang, Ys, Invernizzi, A, Isa, H, Jodar-Marquez, M, Kansupada, K, Kawali, A, Kempen, Jh, Khairallah, M, Krag, S, Kuijpers, R, Laithwaite, J, Lee, St, Lefebvre, P, Lehoang, P, Lobo, Am, Mahendradas, P, Mccluskey, P, Mili-Boussen, I, Mochizuki, M, Moschos, M, Nascimento, H, Nguyen, J, Nguyen, Qd, O'Keefe, G, Oli Mohamed, S, Ozdal, P, Menendez Padron MI, Palestine, A, Paroli, Mp, Pavesio, C, Pichi, F, Pleyer, U, Przezdziecka-Dolyk, J, Rao, N, Rathinam, S, Ribeiro, M, Roy, M, O P, Sabat, Sandhu, Hs, Sittivarakul, W, Smith, J, Smith, W, Somkijrungroj, T, Sood, A, Suelves, A, Tay-Kearney, Ml, Teuchner, B, Thorne, J, Trittibach, P, Tugal-Tutkun, I, Unzueta-Medina, Ja, Santos Valadares ED, Van Os, L, Wells, J, Alvarez, By, Young, S, Zierhut, M., and Surgical clinical sciences
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Adult ,Male ,syphilis ,Penicillins ,EYE ,Eye Infections, Bacterial ,Uveitis ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Copyright policy ,Surveys and Questionnaires ,medicine ,Humans ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Referral and Consultation ,Societies, Medical ,Retrospective Studies ,Medicine(all) ,Practice patterns ,business.industry ,Middle Aged ,medicine.disease ,infection ,Sensory Systems ,Anti-Bacterial Agents ,Syphilis Serodiagnosis ,3. Good health ,Ophthalmology ,inflammation ,eye ,uveitis ,030221 ophthalmology & optometry ,Optometry ,Female ,Syphilis ,business - Abstract
BackgroundSyphilitic 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.Methods103 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.ResultsMembers 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.ConclusionThis comprehensive report by an international group of uveitis-specialised ophthalmologists provides a current approach for the management of syphilitic uveitis.
- Published
- 2019