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. 2020 Jun 25;34(7):1569–1578. doi: 10.1111/jdv.16347

Table 3.

Characteristics of patients with blinding syphilis

Case number Age/Gender Best‐corrected visual acuity（L/R）before treatment Ocular diagnosis* Other syphilis symptoms Serology CSF (W/P) CSF‐VDRL/CSF‐TPPA Treatment Follow‐up (month) Best‐corrected visual acuity（L/R）after treatment
1 61/M 0.02/ NLP Optic atrophy Dysesthesias and weakness of the limbs

RPR1:8

TPPA (+)

 2.2/56 1 : 1/+ Doxycycline0.2 g P.O/day * 30 days 24 0.02/NLP
2 64/F 0.6/NLP Retinitis –

RPR1:128

TPPA (+)

 36/48 1 : 32/+ PCN 24 MUI iv/day *14 days 72 0.6/ LP
3 71/M NLP/NLP Optic neuritis –

RPR1:128

TPPA (+)

 5.5/40 1 : 8/+ PCN 24 MUI iv/day *14 days 80 LP/LP
4 54/F LP/0.1 Optic neuritis –

RPR1:128

TPPA (+)

 53.9/40 1 : 8/+ PCN 24 MUI iv/day *14 days 60 LP/0.1
5 61/M LP/NLP Optic atrophy Dysesthesias in the lower limbs

RPR1:32

TPPA (+)

 30.8/52 1 : 8/+ PCN 24 MUI iv/day *14 days 12 LP/NLP
6 39/M LP/0.04 Optic atrophy –

RPR1:16

TPPA (+)

 0/63 −/+ PCN 24 MUI iv/day *14 days 36 LP/0.04
7 78/M LP/LP Optic atrophy Mental disorder

RPR1:512

TPPA (+)

 105.6/60 1 : 4/+ PCN 24 MUI iv/day *14 days 36 0.5/LP
8 70/M NLP/NLP Optic atrophy Mental disorder

RPR1:64

TPPA (+)

 47.3/73 1 : 4/+ Ceftriaxone 2 g iv/day *15 days 33 NLP/NLP
9 61/F NLP/0.8 Optic neuritis –

RPR1:32

TPPA (+)

 34.1/48 1 : 1/+ PCN 24 MUI iv/day *14 days + prednisone 30 mg/day orally 24 NLP/0.8
10 43/M LP/0.01 Optic atrophy –

RPR1:4

TPPA (+)

 0/95 1 : 8/+ PCN 24 MUI iv/day *14 days 24 LP/0.01
11 62/F 0.6/LP Uveitis –

RPR1:256

TPPA (+)

 32/29 1 : 2/+ PCN 24 MUI iv/day *14 days + methylprednisolone pulse therapy 15 1.2/0.8
12 56/M LP/NLP Optic atrophy Dysesthesias in the left lower limb

RPR1:32

TPPA (+)

 10/99 1 : 8/+ PCN 24 MUI iv/day *14 days 24 LP/NLP
13 57/F 0.02/LP Optic atrophy –

RPR1:64

TPPA (+)

 12/42 1 : 4/+ PCN 24 MUI iv/day *14d+methylprednisolone pulse therapy 24 0.02/LP
14 54/F 0.3/NLP Optic neuritis Dysesthesias in the lower limbs

RPR1:32

TPPA (+)

 134/39 1 : 2/+ PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 12 0.5/LP

15

 52/M LP/0.5 Optic atrophy –

RPR1:32

TPPA (+)

 154/66 1 : 8/+ PCN 24 MUI iv/day *14 days 40 LP/0.5
16 63/M LP/LP Optic atrophy –

RPR1:128

TPPA (+)

 4/88 1 : 1/+ PCN 24 MUI iv/day *14 days 12 LP/LP
17 53/M FC/LP Optic atrophy –

RPR1:128

TPPA (+)

 48/66 1 : 2/+ PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 12 0.12/LP
18 57/F NLP/HM Uveitis –

RPR1:128

TPPA (+)

 140/44 1 : 4/+ PCN 24 MUI iv/day *14 days 9 LP/0.3
19 63/M 0.15/LP Uveitis –

RPR1:512

TPPA (+)

 24/50 1 : 2/+ PCN 24 MUI iv/day *14 days 11 0.6/0.02
20 59/M LP/0.12 Optic atrophy –

RPR1:64

TPPA (+)

 0/61 1 : 4/+ PCN 24 MUI iv/day *14 days 5 LP/0.12
21 48/M LP/0. 25 Optic neuritis –

RPR1:32

TPPA (+)

 70/60 1 : 8/+ PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 12 LP/0.25
22 64/M FC/LP Optic atrophy –

RPR1:8

TPPA (+)

 0/30 1 : 1/+ PCN 24 MUI iv/day *14 days 9 0.02/HM
23 39/M 0.4/FC Optic neuritis –

RPR1:128

TPPA (+)

 2/208 1 : 2/+ PCN 24 MUI iv/day *14 days 22 0.8/0.6
24 31/M 0.6/0.02 Optic neuritis –

RPR1:128

TPPA (+)

 48/34 –/+ Ceftriaxone 2g iv/day *15 days 10 0.8/0.3
25 40/M 0.3/FC Optic atrophy –

RPR1:8

TPPA (+)

 237/55 1 : 4/+ PCN 24 MUI iv/day *14 days 36 0.3/FC
26 73/M 0.3/HM Optic atrophy –

RPR1:64

TPPA (+)

 45/34 1 : 2/+ Ceftriaxone 2g iv/day *15 days 36 0.3/HM
27 51/M 0.5/0.04 Retinitis –

RPR1:2

TPPA (+)

 28/45 −/+ PCN 24 MUI iv/day *14 days 24 0.5/0.04
28 68/F 0.12/FC Optic neuritis Secondary syphilis rash

RPR1:128

TPPA (+)

 22/34 −/+ PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 35 0.12/FC
29 62/M 0.02/0.4 Optic atrophy –

RPR1:16

TPPA (+)

 13/40 1 : 2/+ PCN 24 MUI iv/day *14 days 24 0.02/0.4
30 61/F 0.01/0.4 Uveitis –

RPR1:64

TPPA (+)

 416/67 1 : 8/+ PCN 24 MUI iv/day *14 days 12 0.12/1.2
31 51/F 0.6/0.04 Uveitis –

RPR1:8

TPPA (+)

 294/27 −/+ PCN 24 MUI iv/day *14 days 12 0.8/0.8
32 55/M FC/0.2 Uveitis Dysesthesias in the lower limbs

RPR1:64

TPPA (+)

 174/130 1 : 32/+ PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 16 1.0/1.0
33 48/M 1.2/FC Optic neuritis –

RPR1:32

TPPA (+)

 0/59 −/+ PCN 24 MUI iv/day *14 days 12 1.2/FC
34 69/M FC/FC Optic atrophy –

RPR1:64

TPPA (+)

 0/34 1 : 1/+ Ceftriaxone 2g iv/day *15 days 12 FC/FC
35 60/M HM/0.2 Optic atrophy –

RPR1:32

TPPA (+)

 210/147 1 : 8/+ PCN 24 MUI iv/day *14 days 15 NLP/0.1
36 32/M 0.5/FC Uveitis –

RPR1:512

TPPA (+)

 20/57 1 : 4/+ PCN 24 MUI iv/day *14 days 12 0.8/0.25
37 74/M LP/0.25 Uveitis –

RPR1:16

TPPA (+)

 32/57.4 1 : 4/+ PCN 24 MUI iv/day *14 days 12 LP/0.25
38 55/M NLP/LP Optic atrophy Dysesthesias and weakness of the lower limbs

RPR1:16

TPPA (+)

 4/196 1 : 2/+ PCN 24 MUI iv/day *14 days 12 NLP/LP
39 55/F LP/0.02 Optic neuritis –

RPR1:32

TPPA (+)

 0/27 −/− PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 10 0.1/0.12
40 51/M HM/0.2 Uveitis –

RPR1:64

TPPA (+)

 20/15 1 : 4/+ PCN 24 MUI iv/day *14 days 23 0.3/0.3
41 54/M LP/0.6 Optic atrophy –

RPR1:64

TPPA (+)

 35.2/32 1 : 4/+ Ceftriaxone 2g iv/day *15 days 44 LP/0.6
42 56/M NLP/0.4 Optic atrophy –

RPR1:8

TPPA (+)

 10/62 1 : 2/+ PCN 24 MUI iv/day *14 days 6 NLP/1.0
43 56/M 0.02/0.3 Retinitis –

RPR1:64

TPPA (+)

 46/50 1 : 2/+ PCN 24 MUI iv/day *14 days 6 0.4/0.4
44 42/F 0.02/0.1 Optic atrophy –

RPR1:32

TPPA (+)

 48/28 −/+ PCN 24 MUI iv/day *14 days 12 0.04/0.1
45 54/F NLP/0.2 Optic atrophy –

RPR1:64

TPPA (+)

 18/61 1 : 2/+ PCN 24 MUI iv/day *14 days 6 NLP/0.2
46 46/F FC/0.1 Optic atrophy –

RPR1:16

TPPA (+)

 10/51 1 : 8/+ PCN 24 MUI iv/day *14 days 6 FC/0.1
47 62/M 0.02/0.4 Uveitis –

RPR1:128

TPPA (+)

 10/503 1 : 8/+ PCN 24 MUI iv/day *14 days + prednisone 30mg/day orally 18 0.5/0.5
48 64/M LP/0.04 Optic atrophy –

RPR1:64

TPPA (+)

 28/98 1 : 8/+ PCN 24 MUI iv/day *14 days 6 LP/0.04
49 51/M LP/0.1 Optic atrophy –

RPR1:16

TPPA (+)

 0/145 1 : 2/+ Ceftriaxone 2g iv/day *15 days 6 LP/0.1
50 64/M LP/0.5 Optic neuritis Weakness of the lower limbs

RPR1:64

TPPA (+)

 600/157 1 : 32/+ PCN 24 MUI iv/day *14 days 6 LP/0.5

CSF, cerebrospinal fluid; FC (Counting fingers), ability to count fingers at 1 m distance; HM (Hand motion), ability to distinguish if a hand is moving or not in front of the patient's face; L, left eye; LP (Light perception), ability to perceive any light; NLP (No light perception), inability to see any light or total blindness; P, CSF protein mg/dL (<=45); PCN, aqueous penicillin G; R, right eye; RPR, rapid plasma regain; TPPA, Treponema pallidum particle agglutination; VDRL, Venereal Disease Research Laboratory test; W, CSF WBC count cell μL (0–8).

Optic neuritis is an inflammation that damages the optic nerve, inside or behind the eyeball.

Uveitis is inflammation of the uvea.

Retinitis is inflammation of the retina in the eye, may be caused by several infectious agents.

*

Optic atrophy is degeneration of, or damage to the optic nerve.