Severe acute syphilitic posterior placoid chorioretinitis with complete spontaneous resolution: The natural course

Franco, Mónica; Nogueira, Vanda

doi:10.3205/oc000039

Cited by 13 publications

(5 citation statements)

References 18 publications

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“…SD-OCT showed granular hyperreflective spots at RPE level. However, the longer follow-up compared to Franco et al [ 32 ] showed a progressive worsening of posterior uveitis. Aranda et al described a case of ASPPC [ 34 ] with spontaneous healing.…”

Section: Introductionmentioning

confidence: 76%

“…This peculiarity might suggest ASPPC as an early stage of posterior uveitis. Franco et al [ 32 ] described a spontaneous recovery of the outer retina changes on SD-OCT within 2 weeks. Baek et al [ 33 ] reported a similar untreated case of ASPPC with spontaneous resolution and solved macular placoid anomaly bilaterally.…”

Section: Introductionmentioning

confidence: 99%

“…The reports of spontaneous resolution of ASPPC with late-onset posterior uveitis [ 32 ] opens a discussion on a possible role of the immune system as a modulator of the immune-phenotype of syphilis.…”

Section: Introductionmentioning

confidence: 99%

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Acute syphilitic posterior placoid chorioretinitis: when the great mimicker cannot pretend any more; new insight of an old acquaintance

Neri

Pichi

2022

J Ophthal Inflamm Infect

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Purpose To review the multimodal imaging patterns of Acute Syphilitic Posterior Placoid Chorioretinitis (ASPPC). Methods A systematic review. Results Syphilis has started to attract the attention of researchers once again due to recent surges, with The World Health Organization (WHO) reporting around 12 million new cases per year. When left untreated, syphilis has a mortality rate of 8–58%, with a higher death rate in males. Eye manifestations occur both in secondary and tertiary stages of syphilis, although ocular involvement may occur at any stage of the disease. Syphilis has been always recognized as “the great mimicker” since it can have multiple clinical patterns of presentation. However, Acute Syphilitic Posterior Placoid Chorioretinitis (ASPPC) represents the typical pattern of the disease and can be easily distinguished. In addition, the advent of modern technologies and the progress made in multimodal imaging have provided more details on its identikit: the pattern of pre-retinal, retinal, retinochoroidal and optic nerve involvement can be identified before going through the laboratory work-up for a correct and appropriate investigation of the disease. Conclusion This review highlights the peculiar pattern of ASPPC, by reporting the diagnostic process made by all the imaging techniques used for a correct multimodal imaging assessment.

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Section: Introductionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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Acute syphilitic posterior placoid chorioretinitis: when the great mimicker cannot pretend any more; new insight of an old acquaintance

Neri

Pichi

2022

J Ophthal Inflamm Infect

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“… 7 , 8 ASPPC shows a good response to treatment with penicillin, 9 as in this case, but the clinical course varies greatly among patients, indicating that the inflammation may be the result of an immune response. 10 , 11 …”

Section: Discussionmentioning

confidence: 99%

A case of acute syphilitic posterior placoid chorioretinitis showing improved choroidal blood flow after treatment

Sugiyama

Mouri

Yamagami

et al. 2023

American Journal of Ophthalmology Case Reports

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“…Although systemic treatment of the underlying secondary syphilis or neurosyphilis is generally associated with disease resolution, spontaneous improvement had been reported in the literature. [10][11][12][13] This fact may suggest that ASPPC is the result of cellular immune response that can locally control the infection. Also, it has been postulated that the immune privilege of the eye may play an important role in these spontaneous resolution case reports.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Bilateral Poorly Treated Acute Syphilitic Posterior Placoid Chorioretinitis Complicated with Choroidal Neovascularization: A Case Report

Vieira¹,

Furtado²

2022

IMCRJ

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Purpose To describe a case of long-term poorly treated bilateral acute syphilitic posterior placoid chorioretinitis (ASPPC) complicated with choroidal neovascularization, with a multimodal imaging approach. Patients and Methods Retrospective case report. Analysis of patient’s clinical data. Case Report A healthy 66-year-old man complained of decreased visual acuity in the right eye (RE). He had a past history of bilateral exudative maculopathy of unknown etiology, lasting for more than 10 years and leading to severe and irreversible vision loss on the left eye. The corrected distance visual acuity (CDVA) was 20/63 on the RE and <20/400 on the left eye (LE). On slit-lamp, no anterior chamber reaction was observed, a vitreous haze was present on the RE as well as large, bilateral yellowish lesions in the macula, with exuberant macular atrophy, particularly on the LE. These well-defined lesions were confined to the posterior pole. The spectral domain optical coherence tomography (SD-OCT) showed a flat retinal pigmented epithelium (RPE) detachment with hyperreflective material beneath the RPE and cystoid macular edema on the RE and an exuberant macular atrophy on the LE, with both eyes showing anomalous enlargement of choroidal vessels. The fluorescein angiography showed general hypofluorescence and indocyanine green angiography revealed a heterogeneous pattern. The OCT angiography (OCTA) of the RE demonstrated an anomalous vascular network related to the presence of choroidal neovascularization (CNV). An etiological study was performed and a positive treponemal test (TPHA) was found. The patient experienced visual acuity improvement to 20/25 after systemic treatment with Penicillin and anti-VEGF injections. Conclusion Clinical data and multimodal imaging information suggest that this case represents a complication of long-term untreated bilateral acute syphilitic posterior placoid chorioretinitis (ASPPC) with associated choroidal neovascularization. Once the RE presented signs of active disease, besides intravitreal anti-VEGF, treatment of the underlying disease was essential for visual recovery.

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Severe acute syphilitic posterior placoid chorioretinitis with complete spontaneous resolution: The natural course

Cited by 13 publications

References 18 publications

Acute syphilitic posterior placoid chorioretinitis: when the great mimicker cannot pretend any more; new insight of an old acquaintance

Acute syphilitic posterior placoid chorioretinitis: when the great mimicker cannot pretend any more; new insight of an old acquaintance

A case of acute syphilitic posterior placoid chorioretinitis showing improved choroidal blood flow after treatment

Long-Term Bilateral Poorly Treated Acute Syphilitic Posterior Placoid Chorioretinitis Complicated with Choroidal Neovascularization: A Case Report

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