Multimodal imaging analyses of hyperreflective dot-like lesions in acute syphilitic posterior placoid chorioretinopathy

Multimodal imaging analyses of hyperreflective dot-like lesions in acute syphilitic posterior placoid chorioretinopathy

Author Lima, Luiz H. Autor UNIFESP Google Scholar
de Andrade, Gabriel Costa Autor UNIFESP Google Scholar
Vianello, Silvana Autor UNIFESP Google Scholar
Zett, Claudio Autor UNIFESP Google Scholar
Farah, Michel E. Autor UNIFESP Google Scholar
Belfort, Rubens, Jr. Autor UNIFESP Google Scholar
Abstract Background: Retrospective review of one acute syphilitic posterior placoid chorioretinitis (ASPPC) case with serological evidence of syphilis who had ocular signs and symptoms not attributable to other diseases. Enface and spectral-domain optical coherence tomographySD-OCT were analyzed at the time of presentation and at 1-month visit following initiation of treatment. The study patient underwent standard treatment for neurosyphilis. Results: Ophthalmic examination and imaging studies were consistent with the diagnosis of ASPPC. The patient age was 33 year-old and the baseline visual acuity was 20/400 and 20/80 in the right and left eyes, respectively. At presentation, SD-OCT scans showed disruption and loss of the ellipsoid zone (EZ), small nodular elevations on retinal pigment epithelium (RPE) and punctate hyperreflectivity in the choroid. Enface OCT at the level of RPE and EZ demonstrated multiple hyperreflective dot-like lesions simmetrically distributed within the macular area. These dot-like lesions corresponded to the small nodular elevations on RPE and to disruption/loss of EZ observed with SD-OCT. One month after neurosyphilis therapy, the visual acuity improved and the outer retinal changes partially reversed in both eyes. Conclusions: We report the outer retinal findings and its correlation using both en-face and SD-OCT in a patient with ASPPC. En-face OCT imaging provides a more precise outer retinal layers analyses allowing a better understanding of the ASPPC pathophysiology.
Keywords Acute syphilitic posterior placoid chorioretinitis
En-face optical coherence tomography
Spectral-domain optical coherence tomography
Outer retinal abnormalities
xmlui.dri2xhtml.METS-1.0.item-coverage Heidelberg
Language English
Date 2017
Published in Journal Of Ophthalmic Inflammation And Infection. Heidelberg, v. 7, p. -, 2017.
ISSN 1869-5760 (Sherpa/Romeo, impact factor)
Publisher Springer Heidelberg
Extent -
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000391764400001

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