Clinical features in four patients with syphilitic outer retinopathy

Area of Science:

• Ophthalmology
• Infectious Diseases
• Retinal Imaging

Background:

• Syphilis can affect the eye, leading to various ocular manifestations.
• Syphilitic outer retinopathy is a less common presentation of ocular syphilis.
• Understanding its clinical and imaging features is crucial for timely diagnosis.

Purpose of the Study:

• To describe the clinical and optical coherence tomography (OCT) findings in patients with syphilitic outer retinopathy.
• To highlight the diagnostic utility of OCT in these cases.

Main Methods:

• Retrospective analysis of medical charts from four Japanese male patients.
• Review of fundus examinations, fluorescein angiography, and OCT imaging.
• Serologic tests for syphilis confirmation.

Main Results:

• All patients exhibited reduced visual acuity and varying degrees of myopia (-4.5 to -7.5 diopters).
• OCT revealed characteristic abnormalities, including disrupted ellipsoid zones and hyper-reflective nodules.
• Fundus examination and fluorescein angiography showed subtle or normal findings in most patients.

Conclusions:

• Optical coherence tomography (OCT) findings are highly suggestive for diagnosing syphilitic outer retinopathy.
• The prevalence of myopia in this cohort warrants further investigation into refractive errors in syphilitic retinopathy.
• Prompt diagnosis and treatment with oral amoxicillin led to visual improvement.