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Diffuse Phlebitis in Patients with Syphilitic Outer Retinopathy.

Kun-Hsien Li¹, San-Ni Chen^1,2,3

¹Department of Ophthalmology, Changhua Christian Hospital, Taiwan, Republic of China.

Ocular Immunology and Inflammation

|May 15, 2020

Summary

Syphilitic outer retinopathy can mimic acute zonal occult outer retinopathy (AZOOR). Fluorescein angiography (FA) is crucial for differentiating these conditions, guiding effective antibiotic and steroid treatment for favorable outcomes.

Keywords:

Syphilitic outer retinopathy azoor phlebitis syphilis uveitis

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Area of Science:

Ophthalmology
Infectious Diseases
Medical Imaging

Background:

Syphilitic outer retinopathy is a rare ocular manifestation of syphilis.
It can present with symptoms mimicking other outer retinal diseases like acute zonal occult outer retinopathy (AZOOR).
Accurate diagnosis is essential for appropriate treatment and visual prognosis.

Observation:

Two cases of syphilitic outer retinopathy presented with features similar to AZOOR.
Fundus autofluorescence showed hyperautofluorescence.
Optical coherence tomography revealed ellipsoid zone disruption.

Findings:

Fluorescein angiography (FA) demonstrated diffuse phlebitis, a key differentiator from AZOOR.
Both patients showed clinical improvement following treatment.
Treatment involved antibiotics (penicillin) and corticosteroids.

Implications:

FA is a critical diagnostic tool for distinguishing syphilitic outer retinopathy from AZOOR.
Early diagnosis and treatment with penicillin and steroids lead to favorable visual outcomes.
This highlights the importance of considering syphilis in the differential diagnosis of outer retinopathy.