Farley Nathan, Pellegrini Marco, Marlow Elizabeth, Ruby Alan, Randhawa Sandeep
Associated Retinal Consultants, P.C., Royal Oak, MI, USA.
Ophthalmology Unit, S. Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.
J Vitreoretin Dis. 2020 Aug 27;4(6):515-521. doi: 10.1177/2474126420936193. eCollection 2020 Nov-Dec.
Acute syphilitic posterior placoid chorioretinopathy (ASPPC) is an uncommon and distinct manifestation of ocular syphilis necessitating immediate treatment. ASPPC is attributed to disruption of the choriocapillaris, retinal pigment epithelium, and photoreceptors. Optical coherence tomography angiography (OCTA) can evaluate choriocapillaris vascular flow and may provide further information about ASPPC's disease process.
OCTA images from 7 eyes of 4 patients with ASPPC were compared before and after treatment when available.
All eyes demonstrated increased choriocapillaris vascular flow voids in the distribution of the ASPPC lesions at initial testing. Following treatment, decreased placoid lesion size was associated with decreased flow voids on OCTA along with improved ellipsoid zone integrity in 2 patients.
Disruption of choriocapillaris vascular flow in ASPPC that causes outer retinal changes can improve following treatment as suggested by OCTA imaging. Some cases may continue to demonstrate decreased flow even after appropriate therapy.
急性梅毒性后极部扁平状脉络膜视网膜病变（ASPPC）是一种罕见且独特的眼部梅毒表现，需要立即治疗。ASPPC归因于脉络膜毛细血管、视网膜色素上皮和光感受器的破坏。光学相干断层扫描血管造影（OCTA）可以评估脉络膜毛细血管血流，可能为ASPPC的疾病过程提供更多信息。
对4例ASPPC患者的7只眼睛在治疗前后（如有）的OCTA图像进行比较。
所有眼睛在初次检查时均显示ASPPC病变分布区域的脉络膜毛细血管血流缺损增加。治疗后，扁平状病变大小减小与OCTA上血流缺损减少以及2例患者的椭圆体带完整性改善相关。
OCTA成像表明，ASPPC中导致外层视网膜改变的脉络膜毛细血管血流破坏在治疗后可得到改善。即使经过适当治疗，部分病例可能仍会显示血流减少。
