The total sample obtained in this study was 15 patients and 26 eyes who met the inclusion and exclusion criteria. The majority of the population in this study were men, 14 (93%) people. The largest age group is the 20–30 years age group with 10 (66%) people. Education level was classified into elementary school completion, junior high school completion, high school completion, and tertiary education. The majority of research subjects were high school graduates (86%). A total of 10 (66%) subjects were not married. A total of 7 (47%) people claimed to be heterosexual and 8 (53%) other people were homosexual. Patient demographic characteristics are outlined in Table 1.
In this study, 11 (73%) subjects had bilateral eye manifestations, and 4 subjects had unilateral manifestations. An overview of the lateralization of research subjects is shown in Table 2.
The degree of visual acuity is classified based on ICD-11 which groups visual acuity disorders into mild (visual acuity < 6/12 to 6/18), moderate (visual acuity < 6/18 to 6/60), severe (visual acuity < 6/60). 60 to 3/60), and blindness (visual acuity < 3/60). In this study, 13 (50%) eyes were classified into blindness. The degree of visual impairment of the subjects of this study is described in Table 3.
Table 1
Demographic Characteristic of Subjects
Demographic Characteristics | | Total (n = 15 subjects) | Percentage (%) |
Sex | | |
Male | 14 | 93 |
Female | 1 | 7 |
Age group | | |
20–30 years | 10 | 66 |
31–40 years | 3 | 20 |
> 40 years | 2 | 13 |
Educational level | | |
Primary school graduate | 1 | 6 |
Junior high school graduate | 0 | 0 |
High school graduate | 13 | 86 |
College graduate | 1 | 6 |
Marital status | | |
Married | 5 | 33 |
Not married | 10 | 66 |
Sexual preferences | | |
Heterosexual | 7 | 47 |
Homosexual | 8 | 53 |
Table 2
Laterality | Total (n = 15 subjects) | Percentage (%) |
Bilateral | 11 | 73,3 |
Unilateral (right eye) | 2 | 13,3 |
Unilateral (left eye) | 2 | 13,3 |
The most common clinical manifestations of ocular syphilis in this study were panuveitis in 17 (65%) eyes, followed by optic neuritis (34%) and neuroretinitis (4%).
Table 3
Presenting Visual Acuity of Subjects
Presenting Visual Acuity | Total (n = 26 eyes) | Percentage (%) |
> 6/12 | 1 | 3 |
6/12–6/18 | 4 | 15 |
< 6/18–6/60 | 7 | 26 |
< 6/60–3/60 | 1 | 3 |
< 3/60 | 13 | 50 |
Table 4
Clinical Manifestations of Ocular syphilis
Clinical Manifestations | Total (n = 26 eyes) | Percentage (%) |
Panuveitis | 17 | 65 |
Optic neuritis | 9 | 34 |
Neuroretinitis | 1 | 4 |
In 13 subjects with manifestations of panuveitis, 12 (92%) subjects received oral prednisolone therapy at a dose of 1 mg per kg body weight, 12 (92%) received prednisolone eye drops 10 mg/mL, 11 (84%) received HCl 10 mg/mL mL, and 1 (7%) subject received intravenous methylprednisolone injection at a dose of 4 x 250 mg. A total of 4 people showed ocular manifestations of optic neuritis, and all (100%) patients received mecobalamin 1x500 mg orally and Ca hydrogen phosphate and cholecalciferol 3x1 tablet orally. One subject had clinical manifestations of neuroretinitis, and the subject received mecobalamin 1 x 500 mg orally, Ca hydrogen phosphate and cholecalciferol 3 x 1 tablet, and intravenous injection of methylprednisolone at a dose of 4 x 250 mg. Data regarding therapy for ocular manifestations of research subjects can be seen in Table 5.
All subjects received anti-retroviral (ARV) therapy from an Internal Medicine Specialist. All subjects have also been given a referral letter to a dermatologist and venereal specialist. A total of 11 (73%) subjects had consulted a dermatologist and venereal specialist, while 4 subjects refused to have themselves examined. Nine of 15 (60%) subjects received 2.4 million IU Benzathine Penicillin G therapy intramuscularly, 1 (6%) subject was not willing to be given treatment, and 1 (6%) subject was given an intramuscular injection of 1 g ceftriaxone because he was allergic to penicillin. Data on HIV therapy and syphilis for research subjects can be seen in Table 6.
Table 5
Treatments for Ocular Manifestations
Treatments | | Total (n = 15 subjects) | Persentase (%) |
Panuveitis | 13 | |
Oral methylprednisolone | 12 | 92 |
Prednisolon eye drops | 12 | 92 |
Cyclopentolate eye drops | 11 | 84 |
Intravenous methylprednisolone | 1 | 7 |
Optic neuritis | 4 | |
Oral mecobalamine | 4 | 100 |
Oral Ca hydrogen phosphate+ Cholecalciferol | 4 | 100 |
Neuroretinitis | 1 | |
Oral mecobalamine | 1 | 100 |
Intravenous methylprednisolone | 1 | 100 |
Table 6
Treatments for HIV and Syphilis
Treatments | Total (n = 15 subjects) | Percentage (%) |
HIV treatments | | |
ARV | 15 | 100 |
Syphilis treatments | | |
Intramuscular Benzatin Penicillin G | 9 | 60 |
Intramuscular ceftriaxone | 1 | 6 |
No therapy | 4 | 26 |
Table 7
Comparison of Visual Acuity Before and After Treatments
Visual Acuity
|
Before treatments
(n = 26 eyes)
|
After treatments
(n = 26 eyes)
|
> 6/12
|
1
|
9
|
6/12–6/18
|
4
|
1
|
< 6/18–6/60
|
7
|
6
|
< 6/60–3/60
|
1
|
1
|
< 3/60
|
13
|
9
|
The follow-up period for this research subject ranged from three to 14 months. Normality of data distribution was evaluated with the Shapiro-Wilk test. The Shapiro-Wilk data in this study showed a non-normal distribution of follow-up periods. The median duration of follow-up was 4 (3–11) months with the range of observation duration being 1–14 months.
Table 7 showed a comparison of the degree of visual acuity before and after administration of therapy for oral and systemic manifestations for three months. There was an increase in the number of eyes without visual impairment from 1 (3%) eye before therapy to 9 (34%) eyes after therapy. The number of eyes with blindness also decreased from 13 (50%) eyes before treatments to 9 (34%) eyes after treatments.