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ObservationalInternational ophthalmology · 2026

Clinical and multimodal imaging features of ocular syphilis with posterior segment involvement: a 10-case series.

Lai Wei, Shuang Wei, Zhiyong Wang

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OphthalmologyObservational

Penicillin treatment improved vision in nearly all eyes with ocular syphilis.

Clinical and multimodal imaging features of ocular syphilis with posterior segment involvement: a 10-case series.

Lai Wei … Zhiyong Wang

International ophthalmology · 2026

Background

Ocular syphilis masquerades as posterior uveitis, causing delayed diagnosis.

Methods

A retrospective, observational case series was conducted on 10 consecutive patients (15 eyes; 6 females, 4 males; mean age 48.3 ± 12.1 years) diagnosed with syphilitic posterior uveitis between January 2013 and December 2024.

n = 15 eyes

93.3%

Results

93.3%

vision got better after treatment in nearly every eye tested

n = 15 eyes

More results

(1) Phenotype distribution: ASPPC was the most prevalent posterior-segment lesion (8/15 eyes, 53.3%), followed by optic perineuritis/papillitis (5 eyes, 33.3%) and retinal vasculitis (2 eyes, 13.3%).

The initial misdiagnosis rate was 60% (6/10).

“

Conclusion · 1 of 2

In patients presenting with ocular syphilis as the initial manifestation, ASPPC is the most common posterior segment lesion. Multimodal imaging provides critical diagnostic clues.

Conclusion · 2 of 2

Despite frequent initial misdiagnosis, prompt penicillin therapy yields favorable visual outcomes. Routine syphilis serology screening is strongly recommended for any patient with unexplained posterior uveitis or optic neuropathy.

Post

Clinical and multimodal imaging features of ocular syphilis with posterior segment involvement: a 10-case series.

Penicillin treatment improved vision in nearly all eyes with ocular syphilis.

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