Karti Omer, Top Karti Dilek, Ozkan Ozdemir Hulya, Eskut Neslihan, Zengin Mehmet Ozgur, Kusbeci Tuncay, Saatci Ali Osman
Department of Ophthalmology, Bozyaka Training and Research Hospital, İzmir, Turkey.
Department of Neurology, Bozyaka Training and Research Hospital, İzmir, Turkey.
Neuroophthalmology. 2018 Jul 20;43(3):196-200. doi: 10.1080/01658107.2018.1493515. eCollection 2019 Jun.
A 27-year-old male was presented with a decrease in vision in the left eye. Best-corrected visual acuity was 10/10 in the right eye and counting fingers at 2 m in the left eye. On fundus examination, the left optic disc was oedematous and there was a wide yellowish, well-defined placoid lesion between the temporal vascular arcades with mild vitreous inflammation. However, a small yellowish well-defined placoid lesion was detected in the inferior temporal region of the macula in the right eye. He was diagnosed with posterior placoid chorioretinopathy (PPC), papillitis, and neurosyphilis after performing fundus fluorescein angiography, fundus autofluorescence imaging, optical coherence tomography, serology for human immunodeficiency virus (HIV) and syphilis, and cerebrospinal fluid examination. Intravenous penicillin treatment was commenced as soon as the diagnosis was established. Seven days after treatment initiation, lesions were partially regressed. PPC and papillitis are rare manifestations of ocular syphilis. In addition, neurosyphilis may also accompany these manifestations. Therefore, syphilis should be considered in the differential diagnosis of patients who have PPC or papillitis and all patients should be tested for HIV coinfection and neurosyphilis.
一名27岁男性出现左眼视力下降。右眼最佳矫正视力为10/10，左眼在2米处仅能数指。眼底检查发现，左眼视盘水肿，在颞侧血管弓之间有一个边界清晰的大片淡黄色类脂样病变，伴有轻度玻璃体炎症。然而，右眼黄斑颞下区域发现一个边界清晰的小淡黄色类脂样病变。在进行眼底荧光血管造影、眼底自发荧光成像、光学相干断层扫描、人类免疫缺陷病毒（HIV）和梅毒血清学检查以及脑脊液检查后，他被诊断为后极部类脂样脉络膜视网膜病变（PPC）、视乳头炎和神经梅毒。诊断一经确立，立即开始静脉注射青霉素治疗。治疗开始7天后，病变部分消退。PPC和视乳头炎是眼部梅毒的罕见表现。此外，神经梅毒也可能伴随这些表现。因此，在PPC或视乳头炎患者的鉴别诊断中应考虑梅毒，所有患者均应检测是否合并HIV感染和神经梅毒。
