Swept-Source Anterior Segment Optical Coherence Tomography of a Vascularized Syphilitic Iris Lesion.

PURPOSE: To describe the appearance and resolution of a vascularized iris nodule in a case of ocular syphilis with swept-source anterior segment optical coherence tomography (SS AS-OCT) imaging.

METHODS

Case report.

RESULTS

A 73-year-old male with a history of ocular syphilis presented with anterior uveitis of the left eye characterized by mutton fat keratic precipitates, anterior chamber cells, hypopyon mixed with hemorrhage, and a vascularized iris nodule. SS AS-OCT similarly showed keratic precipitates, anterior chamber cells, and an iris lesion with anterior hyperreflectivity and shadowing. Systemic workup revealed a new syphilis infection with rapid plasma reagin (RPR) titer of 1:512. After completing a 14-day course of intravenous penicillin and topical steroid treatment, there was resolution of these ocular findings.

CONCLUSION

Ocular syphilis should be considered on the differential diagnosis for vascularized iris lesions. Our case demonstrates SS-AS-OCT findings in this rare presentation of ocular syphilis.