June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Syphilitic Retinitis: Phenotypic Presentations and Resolution after Penicillin Therapy
Author Affiliations & Notes
  • David Miguel Hinkle
    WVU Eye Instituute, Morgantown, West Virginia, United States
  • Sidney A Schechet
    Ellman Retina Group, Baltimore, Maryland, United States
  • Marcia D Carney
    University of Maryland, Baltimore, Maryland, United States
  • Mona Kaleem
    University of Maryland, Baltimore, Maryland, United States
  • Stephen Devience
    Case Western Reserve University, Cleveland, Ohio, United States
  • Luke Chang
    Ophthalmology, Medical College of Georgia/Augusta University, Augusta, Georgia, United States
  • Eva DeVience
    Summa Medical Group, Akron, Ohio, United States
  • Footnotes
    Commercial Relationships   David Hinkle, Santen (F); Sidney Schechet, None; Marcia Carney, None; Mona Kaleem, None; Stephen Devience, None; Luke Chang, None; Eva DeVience, American Glaucoma Society (F)
  • Footnotes
    Support  American Glaucoma Society MAPS research grant
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5377. doi:
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    • Get Citation

      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)

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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.

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