Syphilitic acute posterior placoid chorioretinitis in nonimmunocompromised patients

Joseph, A., Rogers, S., Browning, A., Hall, N., Barber, C., Lotery, A., Foley, E. and Amoaku, W.M. (2007) Syphilitic acute posterior placoid chorioretinitis in nonimmunocompromised patients. Eye, 21 (8), 1114-1119. (doi:10.1038/sj.eye.6702504).

Abstract

Purpose: To describe the clinical and angiographic features of three cases of secondary syphilis in immunocompetent patients, which presented as acute posterior placoid chorioretinitis (APPC) to the ophthalmologist.
Methods: Interventional case series. The aetiology of the APPC was confirmed by serology to be secondary syphilis. Optical coherence tomography, electrophysiology, fundus fluorescein, and indocyanine green (ICG) angiography were performed at presentation and after resolution. Appropriate treatment for secondary syphilis was instituted in each patient.
Results: The clinical features, fundus fluorescein and ICG angiography, multifocal electroretinography (mfERG), and optical coherence tomography findings of APPC are described. All three patients had a satisfactory resolution of the APPC with improvement in visual acuity.
Conclusions: APPC in secondary syphilis can occur even in immunocompetent patients. A high index of suspicion is required for early diagnosis of this condition resulting in a good visual outcome with adequate treatment. mfERG and optical coherence tomography are useful in the diagnosis and follow-up of these patients.

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Contributors

Author: A. Lotery

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