Case Report: Multimode Imaging of Chronic Syphilitic Chorioretinitis

Author:

Jiang Zhijian1,Ji Huiying2,Zhang Nan1,Huang Liang1,Dong Jianhong

Affiliation:

1. Department of Ophthalmology, Shanghai Xuhui Central Hospital, Shanghai, China

2. Department of Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China

Abstract

SIGNIFICANCE The clinical manifestations of ocular syphilis may mimic those of other diseases, which may result in a missed diagnosis and delayed treatment. PURPOSE We describe multimodal imaging findings and treatment outcomes of a patient with chronic syphilitic chorioretinitis. CASE REPORT A 40-year-old male patient complained of progressive decreased visual acuity of his left eye for more than 1 year. The best-corrected visual acuity was 20/20 in the right eye and 3/50 in the left eye. Relative afferent pupillary defect and 1+ vitreous cells were detected in the left eye. The authors performed fundus examination, fluorescence angiography, ultrawide-field fundus autofluorescence, structure optical coherence tomography, wide-field montage optical coherence tomography angiography, and visual field. Laboratory tests including a toluidine red unheated serum test (1:32) and the Treponema pallidum antibody (9.01S/CO) showed positive results. Chronic syphilitic chorioretinitis was diagnosed in both eyes. The patient was admitted for administration of intravenous penicillin G for 14 days, followed by intramuscular benzathine penicillin G weekly for three doses. Six months after treatment, the toluidine red unheated serum test ratio had decreased to 1:2 (positive). The best-corrected visual acuity was 20/20 in the right eye and 6/20 in the left eye. The reexamination results showed that the ocular structure and capillaris flow partially recovered. CONCLUSIONS Chronic syphilitic chorioretinitis profoundly affects the structure of the retina and choroid; however, eyes may partially recover after an effective treatment. Ultrawide-field imaging technology has several advantages, such as broader imaging field and more details provided, in determining syphilis-induced ocular disorders.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Optometry,Ophthalmology

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