Spectral domain optical coherence tomography findings in acute syphilitic posterior placoid chorioretinitis

• Published in: Journal of ophthalmic inflammation and infection Vol. 4; no. 1; p. 2
• Main Authors: Burkholder, Bryn M, Leung, Theresa G, Ostheimer, Trucian A, Butler, Nicholas J, Thorne, Jennifer E, Dunn, James P
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 27-01-2014; Springer Nature B.V; BioMed Central Ltd; Springer
• Subjects: Brief Report; Eye diseases; Medical imaging; Medicine; Medicine & Public Health; Ophthalmology; Syphilis; Tomography; Chorioretinis; Optical coherence tomography; Syphilis; Retinal pigment epithelium; Photoreceptor
• ISSN: 1869-5760; 1869-5760
• DOI: 10.1186/1869-5760-4-2

Background
We describe the spectral domain optical coherence tomography (SD-OCT) findings in three patients with acute syphilitic posterior placoid chorioretinitis (ASPPC). The SD-OCT images demonstrate the pathologic changes in ASPPC with a high level of anatomic detail and may provide information about the pathophysiology of the disease.
Findings
We report a series of three consecutive patients seen at the Wilmer Eye Institute in 2012 and 2013 who presented with clinical and laboratory findings consistent with a diagnosis of unilateral ASPPC. Two of the three patients had HIV co-infection with good immune recovery. SD-OCT images from their initial (pre-treatment) presentation demonstrated thickening and hyperreflective nodularity of the choroid-retinal pigment epithelium (RPE) complex, with focal disruption of the overlying photoreceptor inner segment-outer segment junction in the areas corresponding to the retinal lesions seen on clinical examination. These changes improved with intravenous antibiotic treatment over a 3-month period of follow-up.
Conclusions
SD-OCT imaging in ASPPC demonstrates reversible, focal thickening, and nodularity of the RPE with disruption of the overlying photoreceptor inner segment-outer segment junction. We believe that these SD-OCT images support the concept that ASPPC involves an inflammatory process at the level of the choroid-RPE with resultant structural and functional changes in the retinal photoreceptors. Further study with OCT imaging may be helpful in better understanding this disease.