The authors report a multimodal imaging analysis of a case of acute syphilitic posterior placoid chorioretinitis (ASPPC) occurring in a 51-year-old man. Best-corrected visual acuity (BCVA) was 0.5 and 0.8 in the right and left eyes, respectively. The authors performed spectral-domain optical coherence tomography, fundus autofluorescence, fluorescein angiography, and indocyanine green angiography. All of the examinations were suggestive of the diagnosis of ASPPC, a rare manifestation of syphilis that has distinctive anatomical characteristics that are detectable early on with multimodal imaging. Moreover, serological tests were positive for syphilis infection, so the patient received intravenous penicillin G for 14 days. Final BCVA was 1.0 in the right eye and 0.9 in the left eye.
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Ophthalmic Surg Lasers Imaging Retina
. 2019;50:e179–e184.]
Summary
Microbial keratitis (MK) represents one of the main causes of blindness in the world due to corneal scarring, perforation and endophthalmitis. MK remains a challenging public health concern with the need for more effective treatments. Since resistance to therapies has developed over time to several pathogens, ophthalmologists should pay attention to diagnostic procedures. In order to achieve such goal, animal models and novel studies on disease signaling pathways and pathogenesis have given new therapeutic targets. The most common agents include bacteria (ie: Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae and Serratia species), fungi (ie: Fusarium, Aspergillus and Candida species), and protists, such as Acanthamoeba spp. Several innovative treatments have been proposed, such as lipid based therapy and microRNA based therapies. Corneal cross‐linking might become an alternative to standard antibiotic therapy for treatment of bacterial and fungal corneal infections, decreasing microbial resistance to antibiotics and other drugs. Moreover, deep anterior lamellar keratoplasty (DALK) seems to be more appropriate in herpetic infections than perforating keratoplasty (PK).
SummaryUveitis can be a sight‐threatening disease. Inflammation of uveal tract can be divided into: anterior, intermediate, posterior, and panuveitis. Blurred vision, ocular pain, photophobia and floaters are some of the symptoms complained by those who are affected by uveitis. The onset of uveitis can be either acute or insidious, bilateral rather than unilateral. Posterior uveitis is usually associated with vitritis. Anterior chamber cells and flare should be graded according to standardized uveitis nomenclature (SUN) working group. Binocular indirect ophthalmoscopy (BIO) score is used to evaluate the severity of vitritis. Vitreous changes may comprehend: vitreous hemorrhage, vitreous strands, and vitreous traction. A further classification of posterior uveitis depends on the primary site of inflammation, which can identify: retinitis, choroiditis, retinochoroiditis, and chorioretinitis. Posterior pole uveal involvement can be: focal, multifocal, and placoid. Retinal vasculitis can be present. Uveitis might be complicated by anterior and posterior synechiae, which can lead to uveitic glaucoma, cystoid macular oedema, retinal and choroidal neovascularizations, and retinal ischemia.
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