Unilateral focal lesions in the macula as an early presentation of syphilis  

作　　者：Qing Guo Tianxing Liu Xiaoyan Li Dongfang Yin 

机构地区：[1]Department of Ophthalmology,First Hospital Affiliated to Chinese PLA General Hospital [2]Department of Radiology,First Hospital Affiliated to Chinese PLA General Hospital [3]Department of Ophthalmology,Chinese PLA General Hospital

出　　处：《Eye Science》2017年第1期56-59,共4页眼科学报（英文版）

摘　　要：A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity(BCVA) was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography(FFA) revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography(ICGA) demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography(SD-OCT) imaging of the macula showed focal impairment of the inner segment and outer segment(IS/OS). The blood investigation indicated a positive treponema pallidum hemagglutination assay(TPPA) and a rapid plasma reagin test(RPR) of 1:32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1:4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.A 55-year-old male complained of right eye blurry vision for 3 days. His best-corrected visual acuity （BCVA） was 0.2 for the right eye and 1.0 for the left eye. Anterior segment and vitreous body examinations of both eyes were normal. Yellowish-white focal lesions in the macula of the right eye were observed and subtly changes of lesions were found along the superotemporal and inferotemporal arcades in the macula two days later. Fluorescein fundus angiography （FFA） revealed slight fluorescent leakage from the lesions in the macula of the right eye, and segmental venous leakage and optic disc hyperfluorescence were observed in both eyes. Indocyanine green angiography （ICGA） demonstrated that the lesions in the macula of the right eye had hypofluorescence at a late stage and spectral domain optical coherence tomography （SD-OCT） imaging of the macula showed focal impairment of the inner segment and outer segment （IS/OS）. The blood investigation indicated a positive treponema pallidum hemagglutination assay （TPPA） and a rapid plasma reagin test （RPR） of 1：32. After antisyphilitica treatment for 6 weeks, the yellowish-white lesions had vanished and the BCVA was 1.2 followed by restoration of the IS/OS for the right eye, with an RPR of 1：4. In conclusion, ophthalmologists should alert unilateral focal lesions in the macula may be the first sign of syphilis. Prompt treatment is highly effective in resolving vision.

关 键 词：MACULA SYPHILIS fluorescein fundus angiography indocyanine green angiography CHORIORETINITIS posterior uveitis 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]