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2015 ; 8
(3
): 4647-55
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Clinical manifestations of syphilitic chorioretinitis: a retrospective study
#MMPMID26064397
Yang B
; Xiao J
; Li X
; Luo L
; Tong B
; Su G
Int J Clin Exp Med
2015[]; 8
(3
): 4647-55
PMID26064397
show ga
BACKGROUND: Syphilitic chorioretinitis can produce severe vision loss. However,
the clinical manifestations of syphilitic chorioretinitis are still unclear,
particularly during different stages. Herein, we will present our diagnostic
technique for syphilitic chorioretinitis. METHODS: This retrospective study
recruited 109 cases; we performed a clinical evaluation including case history,
serology analysis, fundus photography, fluorescein fundus angiography with or
without indocyanine green angiography, auto-fluorescence, and optical coherence
tomography. RESULTS: 109 were diagnosed with acute syphilitic posterior placoid
chorioretinitis by fundus photograph that revealed filthy, yellowish-white
lesions. For autofluorescence, during early-stage syphilitic chorioretinitis,
hyperfluorescence could be observed. During the convalescence stage, the
fluorescence became hypofluorescence or disappeared. Fluorescein fundus
angiography indicated early-stage transmitted fluorescence or hypofluorescence.
During the venous stage, the lesion area had fluorescent leakage, mostly
accompanied by retinal vasculitis. During the late stage, speckle staining was
observed with optic disc fluorescence. Hypofluorescence or undistinguishable
fluorescence was seen at an early stage with indocyanine green angiography. At an
advanced stage, the lesion had obvious hypofluorescence. Optical coherence
tomography indicated various inner segment/outer segment damage, accompanied by
retinal pigment epithelium impairment. The inner segment/outer segment alteration
could be lessened with treatment. CONCLUSIONS: The clinical manifestations of
syphilitic chorioretinitis include impaired vision, shadow blocking, or photopsia
of one or both eyes. Fundus photography, fluorescein fundus angiography with or
without indocyanine green angiography, autofluorescence, and optical coherence
tomography could be useful accessory examinations. Autofluorescence and optical
coherence tomography could be the main examinations for monitoring disease
progression.