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N. H. Siegel, G. Abedi, A. Oliver, D. Husain; Bilateral Granulomatous Luetic Uveitis and Proliferative Retinopathy Leading to Bilateral Tractional Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6015.
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To report a case of syphilis associated proliferative retinopathy with bilateral tractional retinal detachments in a patient with chronic luetic uveitis.
Case review of retinal patients of Boston University Eye Associates at the Boston Medical Center
A 47-year-old male patient with history of inflammation and decreased vision for three months was referred for evaluation of a left eye retinal detachment. On examination, his best-corrected visual acuity was 20/60 (right eye) and light perception (left eye). He had pigmented keratic precipitates (KP) in the right eye and mutton fat KP in the left eye with anterior chamber reaction. In the left eye he had significant vitreous cells, a tractional retinal detachment along with vitreous hemorrhage. The presence of proliferative retinopathy was observed bilaterally. Work-up for other causes of proliferative retinopathy was unremarkable, with normal blood sugar, blood pressure and negative sickle hemoglobin electrophoresis. Further laboratory workup for uveitis was positive for FTA-Abs and a negative RPR, consistent with latent or late stage syphilis. The patient underwent a two-week course of treatment with intravenous penicillin for treponemal disease three months after initial presentation with improvement in the uveitis bilaterally but with continued progression of the bilateral tractional retinal detachments. Over the course of the subsequent three years in follow up he was noted to have recurrent tractional retinal detachments bilaterally. He underwent vitrectomy with membrane peel and silicone oil with successful repair of his tractional retinal detachments in both eyes.
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