Bilateral Chorioretinitis as Syphilis Presentation: Multimodal Characterization and Therapy Response

Area of Science:

• Ophthalmology
• Infectious Diseases
• Neurosyphilis

Background:

• Syphilis, a sexually transmitted infection, can manifest with diverse ocular complications across all stages of infection.
• Tertiary syphilis, though less common, can present with severe systemic and ocular manifestations.

Observation:

• A case of bilateral syphilitic chorioretinitis is presented as the initial manifestation of tertiary syphilis.
• The patient was immunocompetent, underscoring that syphilis can affect individuals without compromised immune systems.

Findings:

• Multimodal imaging, including Fundus Autofluorescence (FAF), Fluorescein Angiography (FA), and Spectral-Domain Optical Coherence Tomography (SD-OCT), was employed for detailed characterization.
• These advanced imaging techniques provided crucial insights into the pathological changes of syphilitic chorioretinitis.

Implications:

• This case emphasizes the importance of considering syphilis in the differential diagnosis of chorioretinitis, even in immunocompetent individuals.
• Early and accurate diagnosis through multimodal imaging is critical for timely treatment and prevention of vision loss in syphilitic eye disease.