{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:03:15Z","timestamp":1785376995005,"version":"3.55.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T00:00:00Z","timestamp":1719878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Screening for syphilis increasingly relies on positive treponemal rather than nontreponemal tests (rapid plasma reagin [RPR]). We compared ocular syphilis in patients with nonreactive versus positive RPR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational cohort study of ocular syphilis treated at 2 New England hospitals during 1996\u20132021 based on ophthalmologist-diagnosed eye findings and positive treponemal serology, regardless of RPR. We excluded patients with alternative diagnoses. We categorized RPR into nonreactive RPR, low-titer RPR (&amp;lt;1:8), and high-titer RPR (\u22651:8) and compared early and long-term response to therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our sample included 115 patients with ocular syphilis (median follow-up, 2.5 years): 25 (22%) with nonreactive RPR, 21 (18%) low-titer RPR, and 69 (60%) high-titer RPR. Compared with nonreactive and low-titer RPR, people with high-titer RPR were younger (mean 47 years, P &amp;lt; .001), more likely to be male (93%, P &amp;lt; .001) and more likely to be diagnosed with human immunodeficiency virus (49%, P &amp;lt; .001). People with nonreactive and low-titer RPR were less likely than those with high-titer RPR to have posterior uveitis\/panuveitis (32% and 29% vs 75%, P &amp;lt; .001) or abnormal cerebrospinal fluid (26% and 35% vs 75%, P &amp;lt; .001), and more likely to present with chronic eye findings (20% and 29% vs 1%, P &amp;lt; .001). In long-term follow-up, eye findings improved and did not recur in most patients (62% nonreactive, 68% low-titer, 96% high-titer RPR); improved but recurred in 29%, 11%, and 4%, respectively; and were stable in 10%, 21%, and 0%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with ocular syphilis and nonreactive RPR are similar to patients with low-titer RPR, and antibiotic therapy is beneficial in most.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciae354","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T09:22:17Z","timestamp":1719912137000},"page":"1194-1200","source":"Crossref","is-referenced-by-count":5,"title":["Ocular Syphilis in Patients With Nonreactive Rapid Plasma Reagin and Positive Treponemal Serologies: A Retrospective Observational Cohort Study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3761-6154","authenticated-orcid":false,"given":"Amir M","family":"Mohareb","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts, USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam B","family":"Barshak","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts, USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George N","family":"Papaliodis","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Massachusetts Eye and Ear Infirmary , Boston, Massachusetts, USA"},{"name":"Department of Ophthalmology, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Sobrin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Massachusetts Eye and Ear Infirmary , Boston, Massachusetts, USA"},{"name":"Department of Ophthalmology, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene L","family":"Durand","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Massachusetts General Hospital , Boston, Massachusetts, USA"},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts, USA"},{"name":"Department of Ophthalmology, Massachusetts Eye and Ear Infirmary , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,2]]},"reference":[{"key":"2026020907370294500_ciae354-B1","author":"European Centre for Disease Prevention and Control"},{"key":"2026020907370294500_ciae354-B2","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/OLQ.0000000000001355","article-title":"Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2018","volume":"48","author":"Kreisel","year":"2021","journal-title":"Sexual Trans Dis"},{"key":"2026020907370294500_ciae354-B3","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1056\/NEJMra1901593","article-title":"The modern epidemic of syphilis","volume":"382","author":"Ghanem","year":"2020","journal-title":"N Engl J Med"},{"key":"2026020907370294500_ciae354-B4","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1093\/cid\/cix604","article-title":"Increases in ocular syphilis\u2014North Carolina, 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