Journal of Ophthalmology / 2017 / Article / Tab 4

Review Article

Clinical Features and Treatments of Syphilitic Uveitis: A Systematic Review and Meta-Analysis

Table 4

Treatments and outcomes.

StudyInterventionMean follow-up
time (months)
Outcome
Antibacterial agentsSteroidsImmunosuppressantOutcome measuresImprovement or
maintenance
in visual acuity (%)

Bollemeijier (2016)Benzyl PNC 0.15 MU/kg/d IV (14 d),
or procaine PNC 1.2–2.4 MU IV (10–17 d),
or doxycycline 200 mg po bid (28 d),
or ceftriaxone IV 2 g/d (14 d)
±systemic, ±topical, ±subconjunctival6Improvement in visual
acuity, factors associated
with final visual acuity
91.5
Dai (2016)
Fonollosa (2016)74%: penicillin IV or IM, or combined.
Others: oral doxycycline and
ceftriaxone either IM or IV
14Improvement in visual
acuity, ocular complications
90.0
Sahin (2016)PCN 24 MU/day IV (10 d)±systemic±>6Improvement in visual
acuity and inflammation
100.0
Tsuboi (2016)75% benzyl PNC 24 MU/d IV, amoxicillin
po plus probenecid before or after
±systemic21Improvement in visual
acuity and inflammation
100.0
Zhang (2016)All PNC G 18–24 MU/d IV (2 w),
or ceftriaxone 2 g/d IV (2 w)
10.1Improvement in visual
acuity and inflammation
88.0
Lee (2015)Benzyl PNC 18–24 MU/d IV (1014 d),
or IV ceftriaxone (14 d), doxycycline
po (21 d)
1–96Improvement in
visual acuity
100.0
Moradi (2015)PNC IV/IM, or ceftriaxion±systemic±9Incidence of visual loss,
ocular complications
52.0
Northey (2015)Benzyl PNC IV (14 d), benzathine
PNC IM, doxycycline po
±systemic, ±topical6Improvement in visual
acuity and inflammation
87.0
Shen (2015)Benzathine IM or ceftriaxone
IV or doxycycline po
4.1Improvement in
visual acuity
92.3
Mathew (2014)>6Improvement in
visual acuity
93.7
Rodrigues (2014)Crystalline PNC 20 MU/d IV (14 d)±systemicImprovement in
visual acuity
89.5
Yap (2014)PNC IV (10–14 d), or procaine PNC
IM (10 d) + benzathine PNC G IM,
or benzathine penicillin G IM
±systemic, ±topical>3 (10/12 pt.)Improvement in visual
acuity and inflammation
100.0
Restivo (2013)PNC 24 MU/d (14 d)Topical29.4Improvement in visual
acuity and inflammation
71.4
Eandi (2012)PNC 24 MU/d (14 d)Systemic2.9Improvement in visual
acuity and inflammation
100.0
Yang (2012)PNC 18–24 MU/d IV (14–20 d),
or doxycycline po
Systemic (taper)9.3Improvement in visual
acuity and inflammation
94.3
Balaskas (2011)PNC IV, or ceftriaxone±systemic±10Improvement in
visual acuity
84.2
Hughes (2010)PNC IV (10–14 d)±systemicImprovement in visual
acuity and inflammation
100.0
Li (2010)PNC IV (2 w) + PNC G benzathine
IM (1–3 w), or doxycycline po (4 w)
±systemic (taper)Improvement in
visual acuity
100.0
Kunkel (2009)PNC G IV or ceftriaxone (≥10 d)Improvement in
visual acuity
61.5
Fonollosa (2009)PNC G IV 24 MU/d (14 d)±intravitreal19.8Improvement in
visual acuity
100.0
Anshu (2008)Crystalline PNC G (18–24 MU/d)
or procaine
PNC (2–4 MU/d IM) with probenecid
(10–14 d), or ceftriazone 2 g/d (10–14 d)
±systemic, ±topicalImprovement in
visual acuity
82.8
Hong (2007)Crystal PNC G 12–18 MU/d
(6–14 d) + PNC G 2.4
MU/w IM (3-4 w), or PNC IV (10–14 d),
or tetracycline 500 mg po qd (26 d)
±systemic prior
to diagnosis
4.3Improvement in visual
acuity and inflammation
100.0
Parc (2007)PNC G IV, or cetriaxone IV, or
benzathine-benzyl PNC IM
>1 (all pt.); 5 (4 pt.)Improvement in visual
acuity and inflammation
100.0
Tran (2005)PNC 24 MU/day IV (≥14 d), or
ceftriaxone 2 g/day IV (21 d)
7Improvement in visual
acuity and inflammation
100.0
Shalaby (1997)PNC 12–24 MU/d IV (10–14 d),
or ceftriaxone 2 g/d IV (10 d)
Topical>3 (8/13 pt.)Improvement in visual
acuity and inflammation
100.0
Li (2011)PNC IV (≥10 d), or PNC IM,
or ceftriaxone
IM + PCN IV bolus, or tetracycline po
31Improvement in visual
acuity and inflammation
90.9
Ormerod (2001)Benzyl PNC IV (10–14 d), or a
combination of PNC IV + benzathine
PNC IM,
or benzathine PNC IM alone
5Improvement in visual
acuity and inflammation
88.9
Browning (2000)PNC IV (10 d), or benzathine
PNC IM + probenecid po
6Improvement in visual
acuity and inflammation
83.3
Villanueva (2000)Crystalline PNC G 12–24 MU/d IV±topical12.9Improvement in
ocular lesions
Deschenes (1992)PNC 18–24 MU/d IV (10–14 d) + PNC
2.4 MU/w IM, or PNC IM (2-3 w),
or tetracycline
Improvement in
visual acuity
78.9
Tamesis (1990)PNC, no details±topical10Improvement in visual
acuity and inflammation
100.0

ASPPC: acute syphilitic posterior placoid choroiditis; bid: twice daily; CSF: cerebrospinal fluid; d: days; IM: intramuscular; IV: intravenous; MU: million unit; PNC: penicillin; po: per os (oral).

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