Visual analyzer lesions and approaches to treating ophthalmic syphilis in patients with latent syphilis

Almost all eyeball and optic nerve structures are secondarily involved in the pathological process in syphilitic infection. Ophthalmic syphilis is manifested by uveitis, panuveitis, retinal angiopathy, neuritis, optic nerve demyelination and atrophy, necrotizing scleritis, and keratitis.

Objective. To study the forms of damage to the organ of vision in syphilis and the results of their specific treatment.

Subjects and methods. The investigation enrolled 158 patients with latent syphilis. The patients were divided into 4 groups according to the approaches to therapy. Enzyme immunoassay, passive hemagglutination assay, and a set of serological tests were used to estimate the serum levels of anti-Treponema pallidum antibodies in all the patients. To examine the organ of vision, the patients underwent ophthalmoscopy, biomicroscopy, color (red, white, and green) perimetry tests, optical coherence tomography, and critical flicker fusion frequency measurements.

Results and conclusion. The organ of vision is involved in the infectious process in syphilis, which is manifested by the development of uveitis, scleritis, neuritis, optic nerve atrophy, and anterior ischemic neuropathy. Specific penicillin therapy used in the treatment of neurosyphilis has been shown to be effective for organ of vision pathology associated with early latent syphilis. Eye analyzer lesion can be the manifestation of the latent forms of syphilis, which may be recommended as a screening criterion for selection of the patients to be examined for anti-Treponema pallidum antibodies. For effective therapy, ophthalmic syphilis must be detected in the first 2 years of infection, as there are irreversible eye analyzer lesions in the long-term persistence of Treponema pallidum in the macroorganism.