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This abstract is assigned to session Free Paper Session IV: Infectious Disease II
Presentation preference Oral
review resultOral
TitleOcular syphilis in HIV/AIDS patients in India
Accept poster if oral is not possible ?Yes
PurposeTo study clinical profile and management outcome of ocular syphilis in HIV/AIDS patients in the HAART era
MethodsRetrospective study. Included-HIV/AIDS patients with syphilis coinfection seen between 2013-2018 in tertiary eye hospital-min-6 month follow-up. Ophthalmic/systemic examination/investigation details and management outcome analysed
Results30 patients(50 eyes, 20-bilateral)(males-28, females-2, age range 24–60 years) included. Mean duration-HIV diagnosis to ocular presentation-15.95 months. 8 patients were detected with HIV while investigating for ocular disease. CD4 counts range-42-612cells/ Heterosexual-18(males-16,females-2), bisexual-3 and men having sex with men(MSM)–9. Ocular manifestations-panuveitis-commonest-25 eyes, posterior uveitis-14 eyes(retinitis–10, choroiditis-2, vasculitis-2), vitritis-6 eyes, anterior uveitis-4 and atypical optic neuritis-1 eye. Retinitis seen in patients with CD4<100 and placoid choroiditis in CD4>600. Significant inflammation noted despite low CD4 counts(150-300). CSF confirmed neurosyphilis-3 patients. Median RPR titre-1:32, median TPHA-1:1280. All patients treated with HAART, systemic penicillin and steroids. Four patients with recurrences(>6 weeks) and 2 with IRU were retreated with long term penicillin and systemic steroids respectively. At final follow-up, all had reduced titres and inflammation control. Vision improved/stable-38 eyes-mean logMAR-1.205 improving to 0.63
ConclusionPanuveitis, presenting feature in 50%.MSMs higher risk. Atypical retinitis, mimics CMV. IRU, uncommonly can present as CME. HAART, systemic penicillin helps prevents systemic infection and recurrence
Conflict of interestNo
Author 1
Initials of first name(s)S
Author 2
Last nameMenia
Initials of first name(s)N
Author 3
Last nameTyagi
Initials of first name(s)M
Author 4
Last nameBiswas
Initials of first name(s)J
Author 5
Last nameTherese
Initials of first name(s)L