Clinical features in four patients with syphilitic outer retinopathy

To present the clinical findings of patients diagnosed with syphilitic outer retinopathy.

A retrospective clinical study.

The study involved four Japanese men whose medical charts were reviewed and analyzed retrospectively.

All patients declined decimal visual acuity to 0.1, 0.2, 0.4, 0.6, and 0.8. Their fundus appearances were generally normal, except for one patient who displayed faint white dots in the upper macular region. Two patients showed dye leakage from retinal vessels during fluorescein angiography. Optical coherence tomography (OCT) results revealed abnormalities in all patients: three had a disrupted ellipsoid zone (EZ) and hyper-reflective nodules at the retinal pigment epithelium line, while one patient presented with a blurred EZ. The patients had myopia ranging from -4.5 to -7.5 diopters. They were diagnosed with syphilitic outer retinopathy based on the findings from the fundus examination, OCT, and serologic tests and were treated with oral amoxicillin, resulting in improved vision.

The OCT findings are typical for diagnosing syphilitic outer retinopathy. Myopia was prevalent in the four patients, indicating a need for further research on refractive errors in patients with syphilitic outer retinopathy.