Purpose: To identify the predictors of final visual outcome in cases with post fever retinitis (PFR).Methods : This is a retrospective study of cases with diagnosis of post fever retinitis. Color fundus photograph and optical coherence tomography (OCT) parameters at presentation and final visit were analysed. Various factors at presentation [age, systemic illness, best corrected visual acuity (BCVA), area of retinitis and hard exudates, OCT parameters], at final visit (optic disc pallor, OCT parameters) and the treatment modalities used were correlated with BCVA at final visit.Results : Twenty four eyes of 16 patients with PFR were included in the study. Median BCVA at presentation was 6/60 and at final visit was 6/9. By multiple linear regression after adjusting for other variables, for every 1 unit increase in height of SRF at fovea at presentation, the value of final BCVA decreased by 0.001 unit. For every 1 unit increase in extent of EZ loss and subfoveal deposit height, the value of final BCVA decreased by 0.0001unit and 0.004 unit respectively.Conclusion: Height of SRF at presentation, extent of EZ loss and subfoveal deposit height at final visit were associated with poor final BCVA in PFR.
Purpose To describes one case of syphilitic necrotizing retinitis and one case of presumed syphilitic necrotizing retinitis with presence of subhyaloid hypopyon. Case description We report two cases of necrotizing retinitis, which were noted to have yellow boat-shaped lesions at the inferior edge of retinitis resembling subhyaloid hypopyon. The subhyaloid location was confirmed on optical coherence tomography in one case. Both the cases were positive for venereal disease research laboratory test (VDRL) and Treponema pallidum hemagglutination (TPHA). But in one case, polymerase chain reaction (PCR) of the aqueous humor was positive for Pseudomonas aeruginosa and responded well to piperacillin. As piperacillin is effective against Pseudomonas and the efficacy of piperacillin in the management of syphilis is not studied, we may have to consider it as a case of presumed syphilitic retinitis. Discussion Subhyaloid hypopyon is an uncommon presentation and is reported in two cases of syphilitic necrotizing retinitis in literature. Severe infection and necrosis confined to the inner retina leads to collection of white blood cells and necrotic material in the subhyaloid space and would settle down resulting in subhyaloid hypopyon. Two cases of subhyaloid hypopyon reported in literature and 2 cases reported in our article are syphilitic retinitis and is not reported in other entities. Conclusion It is possible that subhyaloid hypopyon may serve as a diagnostic cue in syphilitic necrotizing retinitis.
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