Wolek Michael, Paul Samantha, Seraly Mark, Mehra Ankur, Sobol Warren
Department of Ophthalmology, University Hospitals at Case Western Reserve, Cleveland, OH, USA.
Department of Ophthalmology, Louis Stokes Veterans Affairs Medical Center, Cleveland, OH, USA.
J Vitreoretin Dis. 2025 Aug 3:24741264251358634. doi: 10.1177/24741264251358634.
To describe a case of syphilitic posterior placoid chorioretinopathy, a rare ocular manifestation of syphilis requiring prompt diagnosis and treatment. A single case was evaluated. Multimodality imaging including spectral-domain optical coherence tomography (SD-OCT), en face OCT, and OCT angiography (OCTA) were used to confirm a diagnosis in a patient presenting with symptoms of syphilitic posterior placoid chorioretinopathy. SD-OCT showed nodular hyperreflective thickening of the retinal pigment epithelium (RPE), an attenuated ellipsoid zone, loss of the outer segment/RPE junction, and trace hyperreflective vitreous material. En face OCT showed hyperreflective lesions at the avascular complex layer, and flow voids suggestive of nonperfusion within the choriocapillaris were seen on OCTA. SD-OCT showed resolution of disease after 1 week of treatment with penicillin, but en face OCT and OCTA findings persisted for 1 month before finally resolving. En face OCT and OCTA enable the early detection of placoid lesions and microvascular changes commonly seen in syphilitic posterior placoid chorioretinopathy, allowing for the development of an appropriate treatment plan.
描述一例梅毒性后极部扁平状脉络膜视网膜病变，这是梅毒一种罕见的眼部表现，需要及时诊断和治疗。评估了一例患者。对一名出现梅毒性后极部扁平状脉络膜视网膜病变症状的患者，采用包括频域光学相干断层扫描（SD - OCT）、正面OCT和OCT血管造影（OCTA）在内的多模态成像来确诊。SD - OCT显示视网膜色素上皮（RPE）结节状高反射增厚、椭圆体带变薄、外节/RPE连接部缺失以及微量高反射玻璃体物质。正面OCT显示无血管复合体层有高反射病变，OCTA可见脉络膜毛细血管内提示无灌注的血流缺失。SD - OCT显示青霉素治疗1周后病变消退，但正面OCT和OCTA的表现持续1个月后才最终消退。正面OCT和OCTA能够早期检测到梅毒性后极部扁平状脉络膜视网膜病变中常见的扁平状病变和微血管变化，从而制定合适的治疗方案。
