PURPOSE: To report intravitreal triamcinolone (IVTA)-induced unmasking of ocular syphilis. DESIGN: Two case reports. METHODS: A homosexual, diabetic male with macular edema treated with bilateral IVTA and a male with bilateral panuveitis and macular edema who underwent vitrectomy and IVTA. Both developed occlusive retinal vasculitis and panuveitis postinjection. Syphilis serology was positive although both denied previous symptoms. RESULTS: Intramuscular penicillin lead to resolution of inflammation but both sustained severe loss of vision. Cause-and-effect relationship demonstrated between IVTA and reactivation of syphilis. CONCLUSIONS: Intravitreal corticosteroid can modulate the immune response to intraocular syphilis; vigilance is required, particularly in high-risk patients.
PURPOSE: To report intravitreal triamcinolone (IVTA)-induced unmasking of ocular syphilis. DESIGN: Two case reports. METHODS: A homosexual, diabetic male with macular edema treated with bilateral IVTA and a male with bilateral panuveitis and macular edema who underwent vitrectomy and IVTA. Both developed occlusive retinal vasculitis and panuveitis postinjection. Syphilis serology was positive although both denied previous symptoms. RESULTS: Intramuscular penicillin lead to resolution of inflammation but both sustained severe loss of vision. Cause-and-effect relationship demonstrated between IVTA and reactivation of syphilis. CONCLUSIONS: Intravitreal corticosteroid can modulate the immune response to intraocular syphilis; vigilance is required, particularly in high-risk patients.
Authors: Cassandra C Lautredou; Joshua S Hardin; John R Chancellor; Sami H Uwaydat; Abdallah A Ellabban; Ahmed B Sallam Journal: Case Rep Ophthalmol Med Date: 2018-02-19
Authors: Adrian T Fung; Tuan Tran; Lyndell L Lim; Chameen Samarawickrama; Jennifer Arnold; Mark Gillies; Caroline Catt; Logan Mitchell; Andrew Symons; Robert Buttery; Lisa Cottee; Krishna Tumuluri; Paul Beaumont Journal: Clin Exp Ophthalmol Date: 2020-01-22 Impact factor: 4.207