Atlas of Ophthalmology

Acute Syphilitic Posterior Placoid Chorioretinopathy in Reactivated Syphilis (Colour Photography Posterior Segment)

Acute Syphilitic Posterior Placoid Chorioretinopathy in Reactivated Syphilis (Colour Photography Posterior Segment)
Colour Photography Posterior Segment: large, yellowish, placoid, outer retinal lesion. Patient:76 years of age, male, BCVA 0.7 at OD, 0.6 at OS. Ocular Medical History: blurry vision at OS since 3 years. General Medical History: TPHA tests (TPPA IPAT) in serum positive (Titer <1:80), human immunodeficiency virus test negative, no evidence of neurosyphilis. Purose: to present acute syphilitic posterior placoid chorioretinitis (ASPPC) in an immunocompetent 76-year-old man as reactivated syphilis. Methods: Colour Photography Posterior Segment, FFA, SD-OCT. Findings: Colour Photography Posterior Segment: large, yellowish, placoid, outer retinal lesion. FFA: small focal hyperfluorescence in the area of the hypofluorescent lesion, peripheral multifocal choroiditis with multifocal leakages, diffuse late macular edema, papillary leakage, SD-OCT: cystoid macular edema, epiretinal gliosis. small amount of subretinal fluid. Discussion: Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a rare manifestation of syphilis. (1-3) Fundus and angiographic changes in ASPPC may mimic other chorioretinal diseases, including acute posterior multifocal placoid pigmentepitheliopathy (APMPPE). It was suggested that inflammation-associated perfusion abnormalities of the choriocapillaris contribute to the pathophysiological process. Most cases respond to systemic treatment of the underlying Treponema pallidum infection. Literature: Eandi CM, Neri P, Adelman RA, Yannuzzi LA, Cunningham ET Jr; International Syphilis Study Group. Acute syphilitic posterior placoid chorioretinitis: report of a case series and comprehensive review of the literature. Retina.2012 Oct;32(9):1915-41. Bellmann C Holz FG, Breitbart A, Völcker HE. Bilateral acute syphilitic posterior placoid chorioretinopathy--angiographic and autofluorescence characteristics. Ophthalmologe.. 1999 Aug;96(8):522-8 Szepessy Z, Entz BB, Nagy ZZ. Atypical acute syphilitic posterior placoid chorioretinitis. Ophthalmologe. 2016 Jul 26.
Mösler, Maximilian, Dr.med., Augenklinik, Universität Erlangen-Nürnberg, Deutschland, Erlangen, Deutschland; Michelson, Georg, Prof. Dr. med., Interdisziplinäres Zentrum für augenheilkundliche Präventivmedizin und Imaging, Universität Erlangen-Nürnberg, Deutschland, Erlangen, Deutschland
H58.8 + A52.7
Retina -> Infections (see Systemic Diseases) -> Acute Syphilitic Posterior Placoid Chorioretinopathy in Reactivated Syphilis (Colour Photography Posterior Segment, FFA, SD-OCT)
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