Original Research

A descriptive study of syphilitic uveitis in patients treated at tertiary hospitals in Johannesburg

Kashmira Rawjee, Mokokomadi A. Makgotloe
African Vision and Eye Health | Vol 84, No 1 | a989 | DOI: https://doi.org/10.4102/aveh.v84i1.989 | © 2025 Kashmira Rawjee, Mokokomadi A. Makgotloe | This work is licensed under CC Attribution 4.0
Submitted: 30 August 2024 | Published: 28 January 2025

About the author(s)

Kashmira Rawjee, Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Department of Ophthalmology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Mokokomadi A. Makgotloe, Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Syphilitic uveitis is a ‘great mimicker’ with a myriad of manifestations resembling other forms of inflammation in the eye. A large percentage of patients with syphilitic uveitis in South Africa have HIV co-infection and their clinical features and serological results may be confounded by the presence of HIV.

Aim: This study aimed to describe the clinical features of patients treated for syphilitic uveitis at two tertiary hospitals in Johannesburg.

Setting: The study was conducted at the ophthalmology departments of two tertiary hospitals in Johannesburg.

Methods: A retrospective descriptive case series of patients admitted for treatment of syphilitic uveitis at Charlotte Maxeke Johannesburg Academic Hospital and Chris Hani Baragwanath Hospitals.

Results: From 01 January 2015 to 30 June 2020, 25 patients (44 eyes) were admitted for syphilitic uveitis treatment. Vitritis was the most common sign in 54.5% of the patients (n = 24 eyes) and 23 of these eyes were of HIV positive patients. Anterior chamber cells were in 43.1% of the patients (n = 19 eyes), posterior synechiae in 36.3% (n = 16 eyes), optic disc swelling in 31.8% (n = 14 eyes), pigmentary retinopathy in 18.1% (n = 8 eyes) and ciliary injection in 18.1% (n = 8 eyes). Optic disc swelling was observed in 57.1% (n = 4 eyes) of HIV negative patients. There was an improvement in visual acuity (VA) in 64.3% of eyes (n = 27) and no change in VA in 35.7% (n = 15) of eyes. No deterioration in post-treatment VA was documented.

Conclusion: Majority of the patients admitted for syphilitic uveitis had posterior segment signs, which should prompt a diagnosis of syphilis. The treatment of syphilitic uveitis leads to an improvement in VA.

Contribution: This work contributes to our understanding of syphilitic uveitis presentation in South African hospitals.


Keywords

African; South Africa; syphilis; posterior uveitis; vitritis; posterior placoid chorioretinopathy; HIV

Sustainable Development Goal

Goal 1: No poverty

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