SUPERFICIAL RETINAL PRECIPITATES IN PATIENTS WITH SYPHILITIC RETINITIS
- 1 July 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Retina
- Vol. 30 (7), 1135-1143
- https://doi.org/10.1097/iae.0b013e3181cdf3ae
Abstract
Purpose: The purpose of this study was to describe the occurrence of superficial retinal precipitates in patients with syphilitic retinitis. Methods: This was a retrospective, observational case series of nine eyes of eight patients with syphilitic retinitis associated with superficial retinal precipitates. The clinical, photographic, angiographic, and laboratory records were reviewed. Characteristics and treatment response of these superficial retinal precipitates were observed. Results: All patients were Caucasian men, including 5 men who have sex with men (62.5%) and 6 (75.0%) who were positive for human immunodeficiency virus. None of the patients were previously diagnosed with syphilis. All patients developed panuveitis and a distinctly diaphanous or ground-glass retinitis associated with creamy yellow superficial retinal precipitates. In 3 patients (37.5%), the retinitis had a distinctive wedge-shaped appearance. Five patients (62.5%) had associated retinal vasculitis, 3 (37.5%) had serous retinal detachment, 2 (22.2%) had intraretinal hemorrhage, and 2 (22.2%) had papillitis. Within 2 weeks of initiating intravenous penicillin treatment, 7 patients (87.5%) experienced visual recovery to ≥20/40. All affected eyes showed rapid resolution of clinical signs with minimal alternations of the retinal pigment epithelium in areas of prior retinitis after completion of antibiotic therapy. Conclusion: Characteristic superficial retinal precipitates may occur over areas of syphilitic retinitis. Improved recognition of this highly suggestive clinical sign may aid in early diagnosis and treatment.Keywords
This publication has 33 references indexed in Scilit:
- Syphilitic Punctate Inner Retinitis in Immunocompetent Gay MenOphthalmology, 2009
- Ocular Syphilis—Back Again: Understanding Recent Increases in the Incidence of Ocular Syphilitic DiseaseOcular Immunology and Inflammation, 2009
- Ocular Syphilis Unmasked Following Intravitreal Triamcinolone InjectionOcular Immunology and Inflammation, 2009
- Overview and Diagnosis of Acute Retinal Necrosis SyndromeSeminars in Ophthalmology, 2008
- Update on ocular syphilisCurrent Opinion in Opthalmology, 2006
- The re‐emergence of syphilis among homosexually active men in MelbourneAustralian and New Zealand Journal of Public Health, 2005
- Simultaneous Bilateral Exudative Retinal Detachment and Peripheral Necrotizing Retinitis as Presenting Manifestations of Concurrent HIV and Syphilis InfectionOcular Immunology and Inflammation, 2005
- Ocular Manifestations and Treatment of SyphilisSeminars in Ophthalmology, 2005
- Ocular syphilis: the return of an old acquaintanceEye, 2004
- Cerebrospinal Fluid Abnormalities in Patients with Syphilis: Association with Clinical and Laboratory FeaturesThe Journal of Infectious Diseases, 2004