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Clinical and electrophysiological course of acute syphilitic posterior placoid chorioretinitis
S R Menon1, J Fleischhauer, K Jost
1Department of Ophthalmology, University Hospital, Zurich, Switzerland. s.menon@gmx.net
Background:
Syphilis can affect the anterior as well as the posterior segment of the eye at any stage.
History And Signs:
A 52-year-old man was referred to our clinic because of acute loss of his vision and hearing. Best corrected visual acuity (BCVA) was counting fingers (CF) right and 0.05 left eye, respectively. Fundoscopy revealed bilateral intraretinal macular haemorrhages and a large yellowish edematous lesion involving macula and midperipheral retina. Fluorescein angiography showed diffuse late edema. The visual field showed a defect corresponding to the edematous lesion. The "Ganzfeld" electroretinogram (ERG) was markedly reduced and the multifocal ERG in the affected area was not recordable.
Therapy And Outcome:
VDRL, FTA-Abs and TPHA tests in serum and cerebrospinal fluid were positive. Intravenous penicillin therapy was initiated. BCVA, visual field and ERG eventually recovered completely.
Conclusions:
Syphilis should be considered as a differential diagnosis in any unclear inflammatory ocular condition. Awareness of syphilitic posterior placoid chorioretinitis allows rapid diagnosis and therapy.
