June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN ACUTE SYPHILITIC POSTERIOR PLACOID CHORIORETINOPATHY
Author Affiliations & Notes
  • Antonio Ciardella
    Ophthalmology, Policlinico S Orsola Malpighi, Bologna, Italy
  • Francesco Pichi
    San Giuseppe Hospital, University Eye Clinic, Milan, Italy
  • Emmett Cunningham
    Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA
    Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA
  • J. Michael Jumper
    West Coast Retina Medical Group, California Pacific Medical Center, San Francisco, CA
  • Janet Davis
    Bascom Palmer Eye Institute, University of Miami- Miller School of Medicine, Miami, FL
  • Thomas Albini
    Bascom Palmer Eye Institute, University of Miami- Miller School of Medicine, Miami, FL
  • David Sarraf
    Jules Stein Eye Institute, UCLA, Los Angeles, CA
  • Enrico Bertelli
    Bolzano Central Hospital, Department of Ophthalmology, Bolzano, Italy
  • Mariachiara Morara
    Ophthalmology, Policlinico S Orsola Malpighi, Bologna, Italy
  • Paolo Nucci
    San Giuseppe Hospital, University Eye Clinic, Milan, Italy
  • Footnotes
    Commercial Relationships Antonio Ciardella, None; Francesco Pichi, None; Emmett Cunningham, None; J. Michael Jumper, None; Janet Davis, None; Thomas Albini, Bausch and Lomb (C), Allergan (C), Genentech (F), Eleven Biotherapeutics (C); David Sarraf, Genentech (F), Regeneron (F), Allergan (F), Alcon (F), DORC (F); Enrico Bertelli, None; Mariachiara Morara, None; Paolo Nucci, ALCON (F), BAUSCH &LOMB (F), ALLERGAN (F), ALFA INTES (S), VISUFARMA (F), THEA (F), SOOFT (F), SIFI (F), CHICCO (F), FARMIGEA (S), EUFARMED (S)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2881. doi:https://doi.org/
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      Antonio Ciardella, Francesco Pichi, Emmett Cunningham, J. Michael Jumper, Janet Davis, Thomas Albini, David Sarraf, Enrico Bertelli, Mariachiara Morara, Paolo Nucci; SPECTRAL DOMAIN-OPTICAL COHERENCE TOMOGRAPHY FINDINGS IN ACUTE SYPHILITIC POSTERIOR PLACOID CHORIORETINOPATHY. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2881. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To describe the appearance of Acute Syphilitic Posterior Placoid Chorioretinitis (ASPPC), a rare ocular manifestation of syphilis, on Spectral Domain-Optical Coherence Tomography (SD-OCT) both before and after treatment.

Methods: Ophthalmic examination, imaging studies, and SD-OCT scans of 30 eyes of 19 confirmed ASPPC cases were analyzed both at the time of presentation and at each follow-up visit. Standard treatment for neurosyphilis was given to each patient, including 4 million units of penicillin G administered intravenously every 4 hours for 10 days.

Results: Fundus examination and imaging studies were consistent with previous reports, and confirmed the diagnosis ASPPC. In 13 eyes (43.3%), baseline SD-OCT scans were performed within 1 to 2 days of presentation and revealed a small amount of subretinal fluid (SRF), disruption of the inner segment/outer segment (IS/OS) junction, and hyperreflective thickening of the retinal pigment epithelium (RPE). All 30 eyes were again scanned between day 7 and 9 following presentation and revealed loss of the IS/OS and OS/RPE bands, and irregular hyperreflectivity of the RPE with prominent, nodular elevations, but without SRF. Early disruption of the external limiting membrane (ELM) and punctate choroidal hyperreflectivity were seen in 1/30 (3.3%) and 14/30 (46.6%) eyes, respectively. Vision improved and the outer retinal abnormalities normalized in 28/30 eyes (93.3%) following treatment for neurosyphilis.

Conclusions: Patients with ASPPC show characteristic outer retinal abnormalities on SD-OCT imaging, including disruption of the IS/OS band, nodular thickening of the RPE with loss of the linear OS/RPE junction, and, in some cases, loss of the ELM, accumulation of SRF, and punctate hyperreflectivity in the choroid. Vision improved and these abnormalities reversed following treatment for neurosyphilis in the vast majority of patients.

Keywords: 451 chorioretinitis  
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