Choriorétinite placoïde postérieure syphilitique : aspect en OCT spectral domain

[Role of en face OCT in the diagnosis of syphilitic placoid chorioretinitis]

INTRODUCTION

This is a retrospective case series of three patients presenting with syphilitic chorioretinitis. The diagnosis of syphilis rests on the ophthalmologic clinical exam as well as serologic confirmation. We studied the en face and SD-OCT images upon first consultation and after one month of antibiotic treatment with penicillin G.

RESULTS

Four eyes of three male patients between 40 and 60 years of age all diagnosed with syphilitic placoid chorioretinitis were studied by en face OCT. Visual acuities upon initial presentation were unrecordable. On all the en face OCT examinations of the three patients, numerous small hyperreflective oval lesions were observed within the ellipsoid line and the retinal pigment epithelium around the macula. These lesions corresponded to small elevated nodules in the retinal pigment epithelium and interruptions in the ellipsoid line observed on SD-OCT. One month after treatment for neurosyphilis, the visual acuity had improved, and the outer retinal lesions had partially reversed in these eyes.

CONCLUSIONS

We documented the characteristic lesions of syphilitic placoid chorioretinitis by en face OCT. En face OCT allows a more precise approach to the outer retina for diagnosis and follow-up as well as in understanding the pathophysiology of the disease.