Wide field swept source OCT angiography in acute syphilitic placoid chorioretinitis.

PURPOSE: To describe the clinical and swept source OCT angiographic features of a patient with acute syphilitic posterior placoid chorioretinitis (ASPPC).

OBSERVATIONS: A 67-year-old man presented with acute loss of vision in the left eye. On exam, we noted a yellowish placoid lesion in the macula. Optical coherence tomography (OCT) imaging showed RPE nodularity and disruption of the inner segment-outer segment region in the left eye. Fluorescein angiography showed early hyperfluorescent and late staining within the placoid lesions. Wide field swept source OCT angiography (SS-OCTA) showed macular choriocapillaris perfusion flow deficits. Laboratory tests revealed positive 1:128 rapid plasma reagin titer and fluorescent treponemal antibody absorption (FTA-ABS) tests. OCT imaging revealed complete restoration of the IS-OS boundary layer with near complete resolution of the RPE granularity after adequate penicillin therapy. SS-OCTA showed resolution of choriocapillaris flow deficit in the left eye. Improvement in BCVA correlated with improvement in choriocapillaris perfusion.

CONCLUSIONS AND

IMPORTANCE

This is the first case that describes long-term SS-OCTA findings in ASPPC. SS-OCTA is a fast, safe, and easily repeatable imaging modality that offers valuable insights in our understanding of the pathophysiology and the response to treatment of ASPPC.