Report: Ocular syphilis found in 0.6% of syphilis cases

Issue: January 10, 2017

Eight jurisdictions in the United States reviewed syphilis cases in 2014-2015 and found 0.6% of the patients had symptoms consistent with ocular syphilis, according to a report.

Ocular syphilis clusters were reported in Washington and California in early 2015, prompting the CDC to issue a clinical advisory warning about a potential increase in suspected ocular syphilis cases. Seven jurisdictions then reviewed their syphilis data from Jan. 1, 2014, to Dec. 31, 2015, while Indiana reviewed data from only 2015.

In total, 388 suspected cases of ocular syphilis were identified out of 65,130 syphilis cases from 2014 to 2015, a 0.6% rate. Ocular manifestations ranged from 0.17% to 3.9% in the jurisdictions, with five jurisdictions reporting an increase in ocular syphilis cases. Among 158 patients with a documented eye exam, uveitis was the most common diagnosis (45.6%), followed by retinitis (12.7%), optic neuritis (11.4%) and retinal detachment (3.8%).

Most cases, 362, occurred in men. Of these cases with information available on sex partners, 249 subjects were men who have sex with men. One hundred ninety-eight patients with suspected ocular syphilis were also HIV-positive.

“Public health interventions aimed at both providers and persons at risk are necessary to prevent ocular syphilis and to ensure prompt diagnosis and treatment. All patients diagnosed with syphilis that exhibit ocular manifestations, such as eye pain, blurry vision or vision loss, should immediately be treated for neurosyphilis and be referred for expert ophthalmologic examination. Severe outcomes, including blindness, occur in both HIV-positive and HIV-negative patients,” the authors wrote in the report.

Disclosure: The authors report no relevant financial disclosures.

Published by:

Sources/Disclosures

Collapse

Source:

Oliver SE, et al. MMWR Morb Mortal Wkly Rep. 2016;doi:10.15585/mmwr.mm6543a2.