Syphilitic Optic Neuropathy : 2 Cases Reported
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1116 | Type: Poster | DOI: 10.82333/svnf-fy40
Authors: Neama Bouhazzama* 1 , Imane laabi 2 , mathilde otsasso 3 , zyad Laftimi 3 , ghizlane daghouj 2 , loubna el maaloum 4 , bouchra Allali 4 , asmae elkettani 4
1pediatric ophtalmology,Hospital 20 Aout 1953,casablanca,Morocco;pediatric ophtalmology,hospital 20Aout 1953,casablanca,Morocco, 2pediatric ophtalmology,hospital 20Aout 1953,casablanca,Morocco, 3pediatric ophtalmology,Hospital 20 Aout 1953,casablanca,Morocco, 4pediatric ophtalmology,hospital 20Aout1953,casablanca,Morocco
Purpose
Neurosyphilis is a result of invasion of the central nervous system by Treponema pallidum, which can occur at any stage of syphilis. Optic neuropathy (ON) is a rare and severe manifestation of neurosyphilis. It has declined markedly since the advent of antibiotics. The aim of this work is to describe, in the light of two observations, cases of isolated optic neuropathy of syphilitic origin.
Setting
Ohtalmology departement, August 20th, 1954 Hopital Ibn Rochd University, Centre Faculty of Medicine and
Pharmacy Casablanca Hassan II University, Morocco
Methods
Two cases of isolated optic neuropathy revealing neurosyphilis.
Case1: a 40-year-old male complained of blurred vision in the right eye for 1 month.
Case 2: a 37 years old without any past medical history, who presented with bilateral blindness.
Results
A 40yearsold male complained of blurred vision in the right eye for 1 month. His visual acuity was light perception. The patient had a optic atrophy, no peripapillary haemorrhages, exudates were observed. Neurological examination and brain imaging were normal. positive serologic testing with positive TPHA and negative VDRL, HIV serology was negative. Case 2 A 37 years old without any past medical history, who presented with bilateral blindness. Ophthalmological examination revealed bilateral positive light perception, with bilateral optic atrophy at the fundus. Blood syphilitic serology was positive ; CSF cytochemistry was normal.
Conclusions
Syphilitic optic neuropathy is considered a manifestation of late syphilis.Syphilitic optic neuropathy can be unilateral or bilateral, and manifests as peri-neuritis, anterior optic neuritis or retrobulbar optic neuritis. Peri-neuritis is often asymptomatic. Optic neuritis leads to a rapid decline in visual acuity, rapidly complicated by optic atrophy. The rapid progression of syphilitic optic neuropathy means that optic atrophy can be a revealing feature.