A CASE OF SYPHILITIC RETINITIS IN AN IMMUNOCOMPETENT HOST

Published 2022 - 26th ESCRS Winter Meeting

Reference: P223 | Type: Abstracts | DOI: 10.82333/wbr9-7q38

Authors: Meriem El Alami* ¹ , oumkeltoum jrondi ¹ , chaimae baqadir ¹ , mariam issa mahamat adoudou ¹ , bouchra allali ¹ , loubna el maaloum ¹ , asmaa el kettani ¹

¹pediatric ophtalmology,August 20 hospital,CASABLANCA,Morocco

Purpose

Syphilis causes eye damage in 0.1 to 2.5% of cases. It can affect all eye structures. Syphilitic retinitis is a rare manifestation of secondary syphilis but it can be inaugural of the disease.

Setting

This work is about a case of syphilitic retinitis in a patient who consulted in ophthalmological emergencies of the hospital 20 August 1953 in casablanca.

Methods

The patien is a 48-year-old male, with a history of flu-like episodes for 3 months with dragging oro-pharyngeal pain, skin gummas and perforating plantar ulcer , who consulted urgently for a decrease in visual acuity of the right eye.

Results

Clinical examination found: visual acuity of 4/10 , clear cornea, discrete tyndall, regular round pupil, clear crystalline, moderate hyalitis, vasculitis with extended necrosis range in temporal.

Fluorescein angiography found a temporal hyperfluorescent range associated with papillitis, peripheral vasculitis.
Macular OCT was normal.Faced with this suspicion of acute retinal necrosis an extensive assessment was carried out.
Only syphilitic serology came back strongly positive.

Anti-syphilitic treatment has been proposed according to current recommendations.
Evolution: Within a few days, the treatment resulted in the disappearance of retinal necrosis, vasculitis and hyalite and a good clinical development of the dermatological lesions.

Conclusion

Syphilitic serology must be part of any retinal damage assessment, even when the appearance is very strongly suggestive of acute retinal necrosis of viral origin, especially in people with risky behaviours.
Retinal involvement usually occurs during secondary syphilis.

Its treatment is based on penicillin G intravenously or Extencillin intramuscularly.