Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis

Molina-Socola, F.E.; López-Herrero, F.; Medina-Tapia, A.; Rueda-Rueda, T.; Contreras-Díaz, M.; Sánchez-Vicente, J.L.

doi:10.1016/j.oftale.2017.03.010

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…The true rate of ocular syphilis may be higher than we have reported, because patients with mild visual symptoms may not have been detected by either the clinician or the patient themselves. Whilst ocular syphilis is a treatable disease if it is diagnosed promptly and treated properly delays can lead to serious sequelae including lifelong blindness [24][25][26] . In the pre-antibiotic era, about 9% to 12% of patients with ocular syphilis developed blindness.…”

Section: Discussionmentioning

confidence: 99%

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

Gao

Yan

et al. 2020

Acad Dermatol Venereol

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Background Ocular involvement can occur at any stage of syphilis. Prompt diagnosis and proper treatment of ocular syphilis are vital to avoid long‐term consequences. Objectives To describe the risk factors for ocular syphilis and clinical features of blindness caused by syphilis. Methods We report risk factors for ocular syphilis amongst patients seen at the Shanghai Skin Disease Hospital between October 2009 and October 2017. We identify patients with ocular syphilis resulting in blindness and report the clinical characteristics, laboratory findings and treatment outcomes of these patients. Results A total of 8310 new cases of syphilis were seen, of which 213 patients had ocular disease and 50 patients had blindness due to syphilis. Increasing age and higher RPR titres were associated with ocular involvement but there was no association with HIV status. Blindness in syphilis was restricted predominantly to patients with optic nerve involvement and not patients with isolated uveitis. Fifty patients (and a total of 67 eyes) met the WHO definition of blindness prior to treatment for syphilis. At the end of follow‐up, vision had improved in 24 of 67 eyes (35.8%) after treatment. Successful treatment of uveitis was associated with the best improvement in visual acuity, whilst patient with underlying optic atrophy prior to treatment had the worst visual outcome. Conclusions Ocular involvement is an important manifestation of syphilis which may result in blindness. Our data demonstrate outcomes for ocular syphilis are poor if detected late; early recognition and diagnosis is therefore vital to avoid permanent visual loss.

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Section: Discussionmentioning

confidence: 99%

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

Gao

Yan

et al. 2020

Acad Dermatol Venereol

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“…The acute syphilitic posterior placoid chorioretinitis (ASPPC) is a distinct entity of ocular syphilis, that affects the outer retina and the inner choroid. 1,4,5 Although most cases occur in immunosuppressed patients, particularly in HIV positive, 1,5,6 some reports of ASPPC in immunocompetent patients have been published. ASPPC, first described by Gass et al 7 in 1988, consists of an uncommon manifestation of ocular syphilis.…”

Section: Introductionmentioning

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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A review on ocular findings in mouse lemurs: potential links to age and genetic background

Dubicanac¹,

Radespiel²,

Zimmermann³

2017

Primate Biol.

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Abstract. Mouse lemurs, the world's smallest primates, inhabit forests in Madagascar. They are nocturnal, arboreal and dependent on vision for their everyday lives. In the last decades, the grey mouse lemur became increasingly important for biomedical research, in particular aging research. Experiments which require the combination of visual fitness and old age consequently depend on a solid knowledge of ocular pathologies. Although ocular diseases in mouse lemurs have been described as being common, they have not received much attention so far. Yet it is important to know when and why ocular diseases in captive mouse lemurs may occur. This review aims to provide a comprehensive overview of known ocular findings in mouse lemurs. It summarizes the frequency of ocular findings in captive mouse lemur colonies and points to their likely causes and treatment options based on the evidence available from other animals and humans. In addition, it shall be discussed whether age or genetic background may affect their development. This review may be used as a reference for future studies which require an assessment of visual performance in mouse lemurs and help to evaluate observed clinical signs and ocular diseases. Furthermore, the high incidence of specific diseases may provide new perspectives and set the groundwork for a new animal model for ocular research.

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Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis

Cited by 3 publications

References 9 publications

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

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

A review on ocular findings in mouse lemurs: potential links to age and genetic background

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Syphilitic posterior placoid chorioretinitis as initial presentation of early neurosyphilis

Cited by 3 publications

References 9 publications

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

The importance of proper and prompt treatment of ocular syphilis: a lesson from permanent vision loss in 52 eyes

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

A&#160;review on ocular findings in mouse lemurs: potential links to age and genetic background

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A review on ocular findings in mouse lemurs: potential links to age and genetic background