Klinische Monatsblatter fur Augenheilkunde · 2026
Crucial Role of Spectral Domain OCT in the Diagnosis and Follow-up of Acute Syphilitic Posterior Placoid Chorioretinitis (ASPPC) - a Case Series.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Rizzato Angelica, Hoffmann Laura, Weisskopf Florian, Hatz-Wurziger Katja, Katamay Robert, Kochkorov Asan
Аннотация
ABSTRACT: BACKGROUND: Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a pathognomonic manifestation of ocular syphilis. Although formerly considered as being uncommon, its incidence appears to be increasing in recent years. Advances in multimodal imaging, particularly spectral domain optical coherence tomography (SD-OCT), have provided new insights into its pathophysiology and natural course.
ABSTRACT: CASE SERIES: We present three cases of ASPPC with multimodal imaging and long-term follow-up. Clinical history, fundus findings, fluorescein and indocyanine green angiography, fundus autofluorescence and SD-OCT were reviewed. All patients exhibited systemic symptoms prior to ocular involvement and presented with bilateral uveitis, vitritis, and placoid yellowish macular lesions. SD-OCT demonstrated granular RPE thickening, ellipsoid zone disruption, followed by RPE-nodular elevations. These findings likely reflect an inflammatory response in the choroid and choriocapillaris, causing vascular alterations and metabolic impairment of the RPE and the outer retina. With appropriate systemic antibiotic therapy, OCT findings progressively normalised in parallel with gradual visual acuity improvement over 1 - 2 months.
ABSTRACT: CONCLUSIONS: These cases illustrate the characteristic clinical features of ASPPC and highlight the role of SD-OCT in both diagnosis and follow-up. Prompt recognition of ocular syphilis remains crucial and particularly rewarding for the ophthalmologist, who is often the first to recognise ocular syphilis, thereby preventing life-threatening systemic complications and achieving successful treatment of ocular manifestation.
ABSTRACT: CASE SERIES: We present three cases of ASPPC with multimodal imaging and long-term follow-up. Clinical history, fundus findings, fluorescein and indocyanine green angiography, fundus autofluorescence and SD-OCT were reviewed. All patients exhibited systemic symptoms prior to ocular involvement and presented with bilateral uveitis, vitritis, and placoid yellowish macular lesions. SD-OCT demonstrated granular RPE thickening, ellipsoid zone disruption, followed by RPE-nodular elevations. These findings likely reflect an inflammatory response in the choroid and choriocapillaris, causing vascular alterations and metabolic impairment of the RPE and the outer retina. With appropriate systemic antibiotic therapy, OCT findings progressively normalised in parallel with gradual visual acuity improvement over 1 - 2 months.
ABSTRACT: CONCLUSIONS: These cases illustrate the characteristic clinical features of ASPPC and highlight the role of SD-OCT in both diagnosis and follow-up. Prompt recognition of ocular syphilis remains crucial and particularly rewarding for the ophthalmologist, who is often the first to recognise ocular syphilis, thereby preventing life-threatening systemic complications and achieving successful treatment of ocular manifestation.