Abstract
Purpose :
To describe two distinct presentations of syphilitic fundus features in a series of patients
newly diagnosed with syphilis
Methods :
Retrospective, interventional case series. Serologic confirmation was performed in 16
patients diagnosed with ocular syphilis. Clinical examination, fluorescein angiography and optical
coherence tomography were performed at presentation and following penicillin treatment.
Results :
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 had
bilateral involvement (357.5%). Best-corrected visual acuity (BCVA) was averaged at 20/100 (range
20/25 to hand motion). Posterior segment examinations showed two distinct types 1) discrete, placoid
lesions in the macula consistent with acute syphilitic posterior placoid chorioretinitis or 2) superficial
retinal precipitates with corresponding fluorescein pooling in a segmental pattern. These findings rapidly
resolved after antibiotic therapy.
Conclusions :
In the era of resurgence, ocular syphilis may present with several phenotypes of discrete
retinal lesions. Recognition of the characteristic ocular features may help make the diagnosis and
monitor treatment response.
This is a 2020 ARVO Annual Meeting abstract.