Case Report: Multimode Imaging of Chronic Syphilitic Chorioretinitis.
Journal
Optometry and vision science : official publication of the American Academy of Optometry
ISSN: 1538-9235
Titre abrégé: Optom Vis Sci
Pays: United States
ID NLM: 8904931
Informations de publication
Date de publication:
01 09 2023
01 09 2023
Historique:
medline:
23
10
2023
pubmed:
16
8
2023
entrez:
16
8
2023
Statut:
ppublish
Résumé
The clinical manifestations of ocular syphilis may mimic those of other diseases, which may result in a missed diagnosis and delayed treatment. We describe multimodal imaging findings and treatment outcomes of a patient with chronic syphilitic chorioretinitis. A 40-year-old male patient complained of progressive decreased visual acuity of his left eye for more than 1 year. The best-corrected visual acuity was 20/20 in the right eye and 3/50 in the left eye. Relative afferent pupillary defect and 1+ vitreous cells were detected in the left eye. The authors performed fundus examination, fluorescence angiography, ultrawide-field fundus autofluorescence, structure optical coherence tomography, wide-field montage optical coherence tomography angiography, and visual field. Laboratory tests including a toluidine red unheated serum test (1:32) and the Treponema pallidum antibody (9.01S/CO) showed positive results. Chronic syphilitic chorioretinitis was diagnosed in both eyes. The patient was admitted for administration of intravenous penicillin G for 14 days, followed by intramuscular benzathine penicillin G weekly for three doses. Six months after treatment, the toluidine red unheated serum test ratio had decreased to 1:2 (positive). The best-corrected visual acuity was 20/20 in the right eye and 6/20 in the left eye. The reexamination results showed that the ocular structure and capillaris flow partially recovered. Chronic syphilitic chorioretinitis profoundly affects the structure of the retina and choroid; however, eyes may partially recover after an effective treatment. Ultrawide-field imaging technology has several advantages, such as broader imaging field and more details provided, in determining syphilis-induced ocular disorders.
Identifiants
pubmed: 37585871
doi: 10.1097/OPX.0000000000002052
pii: 00006324-990000000-00141
doi:
Substances chimiques
toluidine red
2425-85-6
Penicillin G
Q42T66VG0C
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
645-653Informations de copyright
Copyright © 2023 American Academy of Optometry.
Déclaration de conflit d'intérêts
Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest.
Références
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