A Case of Traction Retinal Detachment Accompanied by Ocular Syphilis

Abstract

Purpose: We report a first case of traction retinal detachment accompanied by ocular syphilis in Korea.Case summary: A 20-year-old male visited with poor left-eye vision. His best-corrected visual acuity was 0.3; no inflammation was evident in the anterior chamber, but many inflammatory cells were found in the vitreous cavity. Fundus examination revealed inferior exudative and tractional retinal detachment. Optical coherence tomography revealed an epiretinal membrane; fluorescein angiography showed that the inferior (detached) retina did not fluoresce. Syphilis was serologically detected; ceftriaxone (2 g daily) was intravenously injected for 14 days. The vitreous cavity inflammation improved, but the tractional membrane proliferation triggered tractional retinal detachment. We performed vitrectomy to remove the tractional membrane and prescribed intravitreal antibiotics. The patient was discharged after intravenous injection of penicillin G (20 MU daily) for 14 days. Three months after surgery, the best-corrected left-eye visual acuity had improved to 0.8, and no recurrence of the retinal detachment was noted.Conclusions: Patients with ocular syphilis may evidence retinal detachment despite initial prescription of systemic antibiotics. A possible need for surgery should be kept in mind; the prognosis is good if an operation is performed in a timely manner.