Table 2.
Demographic data, serological status, cerebrospinal fluid, OCT, and visual field findings of neurosyphilis patients with ocular symptoms as the initial presentation.
| Case | Age/Sex | Ocular symptom | Ocular sign | Ocular examination | Ophthalmic diagnosis | Serological | CSF |
|---|---|---|---|---|---|---|---|
| Case 1 | 57/F | Reduced vision | Unilateral PLR disappearance | OCT: pRNFL thinning OU | Posterior optic neuritis | TPPA>1:1280 TRUST1:1 |
TPPA 1:160 |
| Case 2 | 38/M | Diplopia | Moderate limited abduction OD | Normal OCT findings, VF: borderline OD, paracentral scotoma in the nasoinferior quadrant OS | Abducens palsy | TPPA+ TRUST1:2 | FAT-ABS+ TPPA 1:1280 |
| Case 3 | 50/M | Ptosis& diplopia | Restricted eye movement OD | VF: multiple non-systematic defects in the 4 quadrants OD, general reduction of sensitivity OS | Oculomotor palsy |
TPPA+ TRUST1:2 | TPPA+ TRUST+ |
| Case 4 | 64/M | Ptosis | Ptosis | Unremarkable | Oculomotor palsy |
TPPA+ TRUST+ |
TPPA+ TRUST+ |
| Case 5 | 53/M | Diplopia | Asymmetrical pupils | Unremarkable | Oculomotor palsy |
TPPA+ TRUST- due to dilution |
TPPA+ TRUST- due to dilution |
| Case 6 | 29/M | Reduced vision OU | Papilledema, retinal vasculitis OU | FFA: dilated retinal vessels with leakage; diffuse telangiectases and leakage of optic disk OU VEP: decreased amplitudes of all waves OU |
Posterior uveitis | TPPA+ TRUST1:64 | TPPA+ TRUST1:64 |
| Case 7 | 49/M | Reduced vision | Unilateral pale optic disk | Gradual VF constriction from periphery | Optic nerve atrophy | TPPA+ | FTA-ABS+ TPPA>1:1280 TRUST1:2 RPR1:4 |
| Case 8 | 62/M | Reduced vision | Unilateral pale optic disk | – | Optic nerve atrophy | TPPA+ TRUST1:8 | TPPA+ TRUST+ |
| Case 9 | 40/M | Reduced vision OU, rotation pain OS | Bilateral dull light reflection | Unremarkable | Posterior optic neuritis | TRUST1:64 TPPA>1:1280 RPR 1:128 |
FTA-ABS+ VDRL1:8 RPR 1:8 |
| Case 10 | 45/M | Reduced vision OS | VF: central scotoma OD; FFA: retinal vein dilation and leakage, ill-demarcated optic disk border at late stage, widow defect of RPE. |
Posterior uveitis | TPPA 1:1280 TRUST 1:64 |
TPPA+ TRUST- due to dilution |
NA, not available; OD, oculus dexter; OS, oculus sinister; OU, oculus uterque; FFA, fluorescein angiography; VF, visual field; RPE, retinal pigment epithelium; VEP, visual evoked potential; OCT, optical coherence tomography; CSF, cerebrospinal fluid; TPPA, treponema pallidum particle agglutination test; RPR, rapid plasma reagin test; and TRUST, toluidine red unheated serum test.