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MULTIMODAL IMAGING OF SYPHILITIC MULTIFOCAL RETINITIS

Curi, Andre L. MD, PhD*; Sarraf, David MD†,**; Cunningham, Emmett T. Jr MD, PhD, MPH‡,§,¶,‖

doi: 10.1097/ICB.0000000000000186
Case Report
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Purpose: To describe multimodal imaging of syphilitic multifocal retinitis.

Methods: Observational case series.

Results: Two patients developed multifocal retinitis after treatment of unrecognized syphilitic uveitis with systemic corticosteroids in the absence of appropriate antibiotic therapy. Multimodal imaging localized the foci of retinitis within the retina in contrast to superficial retinal precipitates that accumulate on the surface of the retina in eyes with untreated syphilitic uveitis. Although the retinitis resolved after treatment with systemic penicillin in both cases, vision remained poor in the patient with multifocal retinitis involving the macula.

Conclusion: Treatment of unrecognized syphilitic uveitis with corticosteroids in the absence of antitreponemal treatment can lead to the development of multifocal retinitis. Multimodal imaging, and optical coherence tomography in particular, can be used to distinguish multifocal retinitis from superficial retinal precipitates or accumulations.

Treatment of unrecognized syphilitic uveitis with corticosteroids in the absence of antitreponemal treatment can lead to the development of multifocal retinitis. Multimodal imaging, and optical coherence tomography in particular, can be used to distinguish multifocal retinitis from superficial retinal precipitates or accumulations.

*Department of Ophthalmology, Instituto de Pesquisa Clinica Evandro Chagas, IPEC, FIOCRUZ, Rio de Janeiro, Brazil;

Retina Disorders and Ophthalmic Genetics Division, Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California;

Department of Ophthalmology, California Pacific Medical Center, San Francisco, California;

§Department of Ophthalmology, Stanford University School of Medicine, Stanford, California;

The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California;

West Coast Retina Medical Group, San Francisco, California; and

**Greater Los Angeles VA Healthcare Center, Los Angeles, California.

Reprint requests: Emmett T. Cunningham, Jr., MD, PhD, MPH, West Coast Retina Medical Group, 1445 Bush Street, San Francisco, CA 94109; e-mail: emmett_cunningham@yahoo.com

Supported in part by the Pacific Vision Foundation (E.T.C.) and the San Francisco Retina Foundation (E.T.C.).

None of the authors have any conflicting interests to disclose.

© 2015 by Ophthalmic Communications Society, Inc.