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Abstract #6121 Published in IGR 2-2

Angle-closure glaucoma as a presumed presenting sign in patients with syphilis

Matsuo T; Taira Y; Nagayama M; Baba T
Japanese Journal of Ophthalmology 2000; 44: 305-308


BACKGROUND: Angle-closure glaucoma is a well-known sequel to syphilitic interstitial keratitis. This study describes angle-closure glaucoma in the absence of corneal opacity as a presumed presenting sign of syphilis. CASES: Two patients presented with angle-closure glaucoma with high peripheral anterior synechiae to the level over Schwalbe's line extending the whole circumference of the angle. Neither corneal opacity nor aqueous inflammation was present. Diffuse or localized retinochoroidal degeneration with pigmentation was found in one eye of one patient and in both eyes of the other patient. OBSERVATIONS: Fluorescein angiography revealed dotted retinal pigment epithelial damage even in normal appearing areas of the fundus. The patients showed a positive test for Treponema pallidum hemagglutination and also a low titer of serological tests for syphilis. No systemic activity, such as skin rashes, had been noted. CONCLUSIONS: Syphilis should be considered in patients presenting high peripheral anterior synechiae involving the whole circumference of the angle even in the absence of preceding interstitial keratitis.

Dr. T. Matsuo, Department of Ophthalmology, Okayama University, Medical School, 2-5-1 Shikata-cho, Okayama City 700-8558, Japan


Classification:

9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)



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