Optical Coherence Tomography Angiography Findings in Patients With Acute Syphilitic Posterior Placoid Chorioretinopathy

Abstract

Purpose: Acute syphilitic posterior placoid chorioretinopathy (ASPPC) is an uncommon and distinct manifestation of ocular syphilis necessitating immediate treatment. ASPPC is attributed to disruption of the choriocapillaris, retinal pigment epithelium, and photoreceptors. Optical coherence tomography angiography (OCTA) can evaluate choriocapillaris vascular flow and may provide further information about ASPPC’s disease process. Methods: OCTA images from 7 eyes of 4 patients with ASPPC were compared before and after treatment when available. Results: All eyes demonstrated increased choriocapillaris vascular flow voids in the distribution of the ASPPC lesions at initial testing. Following treatment, decreased placoid lesion size was associated with decreased flow voids on OCTA along with improved ellipsoid zone integrity in 2 patients. Conclusions: Disruption of choriocapillaris vascular flow in ASPPC that causes outer retinal changes can improve following treatment as suggested by OCTA imaging. Some cases may continue to demonstrate decreased flow even after appropriate therapy.