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Renan Rodrigues, Gustavo Salomao, Heloisa Nascimento, Cristina Muccioli; Yellowish dots in the retina: a new finding of ocular syphilis?. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2918.
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To report the occurrence of pale-yellowish perivascular preretinal dots in twelve patients with ocular syphilis
Prospective study of twenty eyes from twelve patients with syphilitic uveitis. All of them were examined at the Uveitis Sector of the Department of Ophthalmology, between March, 2011 and October, 2012. After confirmation of Syphilis diagnosis, Fundus photographs and OCT were performed to identify the localization of the yellowish dots
Demographic data comprised eleven males (91,6%), mean age of presentation was 38,1 years, 4 patients had bilateral panuveitis (30%), 1 had unilateral retinitis (8,3%), 3 had unilateral panuveitis (25%), 1 had anterior uveitis (8,3%), 1 had bilateral optic neuritis (8,3%), 1 had bilateral posterior uveitis (8,3%), 1 had assimetric bilateral uveitis (8,3%). Cerebral Spinal Fluid was positive in 2 patients (16,6%), negative in 7 patients (58,3%), and not collected in 2 cases. Blood VDRL was positive in 8 cases (66,6%%) and negative in 4 patients (33,3%), whereas all patients had positive blood FTA-Abs . The majority of patients had improvement of visual acuity with the treatment (66,6%) whereas 4 patients had no improvement. From all patients, 8 patients were HIV positive (66,6%)
Although not yet recognized in the literature as a typical manifestation of ocular syphilis, these findings are very common in clinical practice. We believe that these dots are caused by the development of perivasculitis secondary to the infection by the treponema. Other authors suggest that they can be granulomas, but more studies, especially patologic studies, are needed. It is important to recognize these findings and remember that syphilis can present with several forms. To conclude, the ophthalmologist must always consider syphilis in the differential diagnosis of uveitis
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