Early Resolved Acute Syphilitic Posterior Placoid Chorioretinitis

Ji, Yong‐Sok; Yang, Jae‐Ho; Park, Sangwoo

doi:10.1097/opx.0000000000000531

Cited by 14 publications

(13 citation statements)

References 5 publications

(4 reference statements)

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“…Similar to our report, it has been documented in immunocompetent patients. Franco et al and Ji et al reported findings of ASPPC in immunocompetent patients with spontaneous resolution without receiving any therapy 4 , 5 . On the other hand, our patient was initially treated with immunosuppressive therapy which is often not a suggested therapy for syphilis.…”

Section: Discussionmentioning

confidence: 64%

See 1 more Smart Citation

Acute syphilitic posterior placoid chorioretinopathy: An infectious or autoimmune disease?

Ormaechea

Hassan

Nguyen

et al. 2019

American Journal of Ophthalmology Case Reports

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PurposeTo report a case of acute syphilitic posterior placoid chorioretinopathy (ASPPC) that demonstrated partial resolution with immunosuppressive therapy secondary to a misdiagnosis as Behçet's disease followed by a relapse which was successfully treated with the appropriate treatment.ObservationsA 34-year-old female patient presented to our service with complaints of decreased vision in the left eye (OS). She initially developed similar symptoms seven months prior to presentation and was diagnosed as Behçet's disease based on the clinical picture of papillitis, vasculitis and placoid chorioretinitis in the posterior pole of OS. She was started on daily oral prednisone 60 mg and weekly methotrexate 10mg by her rheumatologist. The patient's ocular symptoms improved one month prior to presentation with resolution of the placoid lesion but persistence of vasculitis and papillitis. At that time, the dose of the prednisone was decreased to 30 mg which resulted in a relapse of the placoid chorioretinal lesions and worsened visual acuity at the time of presentation to us. Extensive laboratory workup demonstrated positive serology for syphilis. A diagnosis of syphilitic placoid chorioretinitis was made and the patient was treated with intravenous penicillin G for 2 weeks. The vitritis, papillitis, and placoid chorioretinitis resolved along with improvement in vision following the treatment.Conclusions and importanceOcular findings in syphilis are heterogeneous and may mimic variety of ocular diseases. ASPPC is a rare ocular manifestation of syphilis and its natural course and underlying pathophysiology is not well understood. However, irrespective of the underlying mechanism of the disease, all patients with ASPPC should receive treatment to prevent recurrence and long-term functional damage.

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Section: Discussionmentioning

confidence: 64%

“…ASPPC is a rare ocular manifestation of syphilis and its natural course is not well known 4, 5, 6 , 11 . It is characterized by the development of a placoid macular deposit in the outer retina 12 .…”

Section: Discussionmentioning

confidence: 99%

Acute syphilitic posterior placoid chorioretinopathy: An infectious or autoimmune disease?

Ormaechea

Hassan

Nguyen

et al. 2019

American Journal of Ophthalmology Case Reports

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“…To the best of our knowledge, spontaneous resolution of ASPPC before initiation of systemic antimicrobial treatment has been reported in 5 cases [ 10 ], [ 11 ], [ 12 ], [ 13 ]. The first cases were described in 2015 by Ji et al [ 10 ], who reported two HIV-negative patients with ASPPC which spontaneously improved 10 days (for the first case) and 3 weeks (for the second case) after presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Since patients with ASPPC usually receive prompt antimicrobial treatment after serologic results, little is known about the natural course of the disease. To the best of our knowledge, only 5 cases of ASPPC with spontaneous improvement have been reported [ 10 ], [ 11 ], [ 12 ], [ 13 ]. We report the natural course and the multimodal retinal imaging features of an additional case, and discuss the pathogenetic implications and the importance of early recognition of this rare clinical entity.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous resolution of acute syphilitic posterior placoid chorioretinitis: reappraisal of the literature and pathogenetic insights

Casalino

Erba

Sivagnanavel

et al. 2020

GMS Ophthalmology Cases; 10:Doc26

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“…Subretinal fluid accumulation can presented in cases of ASPPC[ 3 ] and spontaneously resolved fluid accumulation can occur within these patients even without treatment. [ 6 7 ] Unlike CSCR, in which the ellipsoid zone recovers when subretinal fluid accumulation is resolved,[ 8 ] patients with ASPPC presented with ellipsoid zone loss and scattered RPE nodules after spontaneous subretinal fluid resolution. [ 3 9 ] FA applied to our patient's eyes also revealed vitreous opacity and retinal phlebitis, which suggested the involvement of inflammation or infectious disease instead of CSCR.…”

Section: Discussionmentioning

confidence: 99%

Acute syphilitic posterior placoid chorioretinopathy mimicking central serous chorioretinopathy: A case report

Huang

Kang

Chen

et al. 2018

Taiwan J Ophthalmol

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A 51-year-old man had experienced declining visual acuity for 4 months. His best-corrected visual acuity was 20/40 in both eyes. Ophthalmoscopic examination showed a yellowish placoid lesion over the macular area, and spectral-domain optical coherence tomography (SD-OCT) revealed subretinal fluid accumulation in the left eye, which resembled that seen with central serous chorioretinopathy (CSCR). Three days later, fluorescein angiography (FA) revealed fluorescein leakage, and indocyanine green angiography (ICGA) showed hypofluorescence over the lesion. Persistent ellipsoid zone loss as spontaneously resolved subretinal fluid was noted at the same time with SD-OCT. Laboratory examination disclosed positive rapid plasma reagin and Treponema pallidum particle agglutination tests (titer >1:1280), which confirmed the diagnosis of ocular syphilis. Acute syphilitic posterior placoid chorioretinopathy (ASPPC) could mimic CSCR with spontaneously resolved subretinal fluid observed in SD-OCT images. The acute loss of the ellipsoid zone, mismatched results from SD-OCT and FA, and picture of retinitis can also provide hints for differentiating the two diseases.

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Early Resolved Acute Syphilitic Posterior Placoid Chorioretinitis

Abstract: In patients with ASPPC, fundus and OCT findings can spontaneously recover during the early clinical course before treatment.

Cited by 14 publications

References 5 publications

Acute syphilitic posterior placoid chorioretinopathy: An infectious or autoimmune disease?

Acute syphilitic posterior placoid chorioretinopathy: An infectious or autoimmune disease?

Spontaneous resolution of acute syphilitic posterior placoid chorioretinitis: reappraisal of the literature and pathogenetic insights

Acute syphilitic posterior placoid chorioretinopathy mimicking central serous chorioretinopathy: A case report

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