ABSTRACT
This review aims to provide an update on the clinical presentation, diagnosis, and treatment of ocular syphilis. While ocular syphilis is not a new phenomenon, recent resurgence in the incidence of overall syphilis, particularly among HIV-positive individuals, has sparked a new interest in an old disease. The challenge of ocular syphilis is manifold: firstly, it manifests in a spectrum of ways that can occur at any stage of the disease, with the most common finding being panuveitis. It may occur as early as 6 weeks after transmission and may be the only presenting feature of systemic syphilis; secondly, the relationship between HIV and syphilis has been established, as primary syphilis facilitates HIV transmission and HIV may modify the natural course of syphilis, increasing the propensity of the disease to progress to neurosyphilis. The authors present the latest updates to the changing landscape of ocular syphilis.
Subject(s)
Eye Infections, Bacterial , Syphilis , Anti-Bacterial Agents/therapeutic use , Antiviral Agents/therapeutic use , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/epidemiology , HIV Infections/diagnosis , HIV Infections/drug therapy , HIV Infections/epidemiology , Humans , Syphilis/diagnosis , Syphilis/drug therapy , Syphilis/epidemiology , Syphilis Serodiagnosis , Uveitis/diagnosis , Uveitis/drug therapy , Uveitis/epidemiologyABSTRACT
Infectious endophthalmitis is an important cause of vision loss worldwide. This entity most often occurs as a complication of intraocular surgery especially following cataract surgery or intravitreal injection. Endophthalmitis is regarded as a serious complication following ocular surgery and the final visual outcome is fundamentally contingent on timely recognition and intervention. Intravitreal and oral antibiotics in combination with pars plana vitrectomy or vitreous aspiration remain the mainstay in the management of endophthalmitis. However, significant inflammation may persist even after sterilization of the intraocular cavities with appropriate antibiotics resulting in failure of treatment. This forms the basis for the use of intravitreal corticosteroids as an adjuvant to antibiotics in the management of infectious endophthalmitis. In the index manuscript, we review the existing literature to determine the role of intravitreal corticosteroids as an adjuvant to antibiotics in treating infectious endophthalmitis, and discuss their beneficial effects and controversial concerns.
