{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T21:24:19Z","timestamp":1781731459365,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to investigate ocular manifestations in patients with neurosyphilis and their association with general indexes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study was conducted among patients who were hospitalized for neurosyphilis from 2012 to 2022. Clinical manifestations, laboratory tests, brain MRI, and ocular examinations were reviewed and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 106 neurosyphilis patients were included, of which 10 patients presented with ocular signs as their initial symptoms. The most common main complaint was reduced vision (6\/10), followed by diplopia (2\/10) and ptosis (2\/10). The causes of vision loss included optic neuropathy (4\/6) and posterior uveitis (2\/6), with all six patients showing optic nerve involvement. A total of 29 (27.4%) patients exhibited pupil abnormalities. A lumbar puncture was performed on all 106 patients, and abnormal cerebrospinal fluid (CSF) findings were revealed in 101 (95.3%) patients, indicating central nervous involvement. The median white blood cell count in the CSF of the patients with pupil abnormalities was significantly higher than that of those without pupil abnormalities (14.0 vs. 6.0 cells\/\u03bcl, <jats:italic>p<\/jats:italic> =\u20090.037). In addition, the patients with abnormal pupillary light reflex (PLR) were more likely to have multiple brain lesions compared to those with normal PLR (77.3% vs. 29.2%, <jats:italic>p<\/jats:italic> &amp;lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Optic nerve involvement is the main cause of vision loss in neurosyphilis. Patients with optic neuropathy or posterior uveitis should undergo prompt diagnostic evaluation for syphilis. Pupil abnormalities can serve as indicators of more severe CSF and MRI findings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1472274","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T05:11:31Z","timestamp":1732770691000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Ocular findings in neurosyphilis: a retrospective study from 2012 to 2022"],"prefix":"10.3389","volume":"15","author":[{"given":"Huanhuan","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haocheng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqi","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.1017\/S0950268814002830","article-title":"Syphilis: antibiotic treatment and resistance","volume":"143","author":"Stamm","year":"2015","journal-title":"Epidemiol Infect"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1093\/cid\/ciz331","article-title":"A nationwide spatiotemporal analysis of syphilis over 21 years and implications for prevention and control in China","volume":"70","author":"Tao","year":"2020","journal-title":"Clin Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/jdv.18604","article-title":"Comparison of molecular and serological assays on cerebrospinal fluid for the diagnosis of neurosyphilis","volume":"37","author":"Salle","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/09273948.2017.1371765","article-title":"Ocular syphilis: an update","volume":"27","author":"Dutta","year":"2019","journal-title":"Ocul Immunol Inflamm"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1136\/bjophthalmol-2019-315699","article-title":"Clinical and laboratory characteristics of ocular syphilis and neurosyphilis among individuals with and without HIV infection","volume":"105","author":"Mathew","year":"2021","journal-title":"Br J Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1177\/1352458520937281","article-title":"Visual field loss and structure-function relationships in optic neuritis associated with myelin oligodendrocyte glycoprotein antibody","volume":"27","author":"Deschamps","year":"2021","journal-title":"Mult Scler"},{"key":"ref7","year":"2021"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1080\/09273948.2019.1672193","article-title":"Neurosyphilis cerebrospinal fluid findings in patients with ocular syphilis","volume":"29","author":"Bazewicz","year":"2021","journal-title":"Ocul Immunol Inflamm"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"5394","DOI":"10.1167\/iovs.14-14559","article-title":"British ocular syphilis study (BOSS): 2-year national surveillance study of intraocular inflammation secondary to ocular syphilis","volume":"55","author":"Mathew","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.15585\/mmwr.mm6543a2","article-title":"Ocular syphilis - eight jurisdictions, United States, 2014-2015","volume":"65","author":"Oliver","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"910337","DOI":"10.3389\/fimmu.2022.910337","article-title":"Demographic, clinical and laboratory characteristics of ocular syphilis: 6-years case series study from an eye center in East-China","volume":"13","author":"Sun","year":"2022","journal-title":"Front Immunol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1097\/OLQ.0000000000000703","article-title":"Diplopia: an overlooked feature in patients with neurosyphilis. 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