Abstract
Syphilis is an historical disease that has persisted to modern times despite effective antibiotic treatment. It is increasing in frequency, reaching 8.7 cases of acquired primary or secondary syphilis per 100,000 people in 2015–2016 in the United States, mainly among men, especially those who have sex with men or are HIV infected, and 15.7 cases of congenital syphilis among 100,000 live births in 2016. Ocular syphilis can affect the uveal tract with iritis or choroiditis, and the retina with retinitis or vasculitis, often accompanied by vitreous inflammation, subretinal fluid and outer retinal damage. Optic nerve disease can lead to optic atrophy. In the healed state, retinochoroidal infection usually leads to milder scarring changes than viral retinochoroiditis. Diagnosis is preferentially with a serologic treponemal test followed by a non-treponemal test. Treatment is preferentially with intravenous penicillin. Evaluation of cerebrospinal fluid for positive non-treponemal tests or evidence of inflammation is essential.
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Alhumaid, S., Davis, J.L. (2020). Syphilis. In: Yu, H. (eds) Inflammatory and Infectious Ocular Disorders. Retina Atlas. Springer, Singapore. https://doi.org/10.1007/978-981-13-8546-9_19
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