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David Miguel Hinkle, Sidney A Schechet, Marcia D Carney, Mona Kaleem, Stephen Devience, Luke Chang, Eva DeVience; Syphilitic Retinitis: Phenotypic Presentations and Resolution after Penicillin Therapy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5377.
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© ARVO (1962-2015); The Authors (2016-present)
To describe two distinct presentations of syphilitic fundus features in a series of patientsnewly diagnosed with syphilis
Retrospective, interventional case series. Serologic confirmation was performed in 16patients diagnosed with ocular syphilis. Clinical examination, fluorescein angiography and opticalcoherence tomography were performed at presentation and following penicillin treatment.
Sixteen patients (23 eyes) were included in the analysis. The mean age of 47.6 years (range 24-59 years). Fourteen patients were male (87.5%), 11 patients tested positive for HIV (68.8%), and 6 hadbilateral involvement (357.5%). Best-corrected visual acuity (BCVA) was averaged at 20/100 (range20/25 to hand motion). Posterior segment examinations showed two distinct types 1) discrete, placoidlesions in the macula consistent with acute syphilitic posterior placoid chorioretinitis or 2) superficialretinal precipitates with corresponding fluorescein pooling in a segmental pattern. These findings rapidlyresolved after antibiotic therapy.
In the era of resurgence, ocular syphilis may present with several phenotypes of discreteretinal lesions. Recognition of the characteristic ocular features may help make the diagnosis andmonitor treatment response.
This is a 2020 ARVO Annual Meeting abstract.
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