Study links symphilitic uveitis to inflammatory ocular hypertension syndrome

Syphilitic uveitis should be considered as a possible cause of inflammatory ocular hypertension syndrome, according to a study by researchers in California.

Emmett T. Cunningham Jr., MD, PhD, and colleagues at the University of California, San Francisco, reviewed records for 39 consecutive patients who had uveitis and serological evidence of syphilis to determine the prevalence and clinical features of inflammatory ocular hypertension syndrome (IOHS). They published their findings in the December edition of British Journal of Ophthalmology.

Investigators defined IOHS as an increase in IOP of more than 21 mm Hg that coincided with the onset of "acute, recurrent or chronic anterior chamber inflammation and reversed promptly with appropriate anti-inflammatory or antimicrobial treatment," the authors said.

Overall, eight eyes of seven patients (18%) had IOHS, compared with a reported prevalence of 2.3% for the uveitis population in general (P < .001), according to the study.

IOP averaged 36 mm Hg, ranging from 23 mm Hg to 51 mm Hg. Best corrected visual acuity averaged 20/40, ranging from 20/20 to 20/200.

Of the eight eyes with IOHS, three had granulomatous traits, including large keratic precipitates, and two eyes had Koeppe nodules, according to the study.