{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:51:14Z","timestamp":1785423074776,"version":"3.56.0"},"reference-count":33,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T00:00:00Z","timestamp":1539734400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Ocular manifestations of syphilis have been reported in 2\u201310% of systemic infection. The purpose of this study was to report the incidence of ocular syphilis and various ocular manifestations, particularly optic nerve involvement, in newly diagnosed cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective study. Medical records of newly diagnosed syphilis patients between January 2009 and January 2017 in a tertiary medical centre were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 123 new systemic syphilis cases out of 569,222 (0.02%) admissions to the Tel Aviv Medical Center during the study period. Ninety\u2010three of the 123 patients (76%) underwent ophthalmological examination. Twenty\u2010three of the 93 patients (25%, mean age 48.6\u00a0\u00b1\u00a012.9\u00a0years, 20 males) had ocular syphilis, and in 12\/23 (52%) patients, the ocular symptoms and findings prompted syphilis investigation. Eighteen of the 23 (78%) had optic nerve involvement, and the most common was inflammatory disc oedema. Older age (p\u00a0=\u00a00.0005) and tertiary stage disease (p\u00a0=\u00a00.0441) were associated with ocular manifestations and the presence of optic nerve findings. Human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>) was associated with ocular but not optic nerve findings. Treatment included intravenous penicillin G, and four patients with severe optic neuropathy were also treated with systemic corticosteroids. Visual acuity significantly improved in most patients (p\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ocular syphilis was found in one\u2010quarter of the patients diagnosed with systemic syphilis and preceded the diagnosis of systemic disease in one\u2010half of them. Optic nerve involvement was a common manifestation. A high index of suspicion for <jats:italic>Treponema<\/jats:italic> infection is required in patients presenting with optic nerve involvement to facilitate prompt diagnosis and treatment. Post\u2010treatment visual outcome was good.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13963","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T08:11:05Z","timestamp":1539763865000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["The great imitator on the rise: ocular and optic nerve manifestations in patients with newly diagnosed syphilis"],"prefix":"10.1111","volume":"97","author":[{"given":"Ainat","family":"Klein","sequence":"first","affiliation":[{"name":"Division of Ophthalmology Tel Aviv Sourasky Medical Center Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1339-8770","authenticated-orcid":false,"given":"Naomi","family":"Fischer","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology Tel Aviv Sourasky Medical Center Sackler Faculty of 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