Acute Syphilitic Posterior Placoid Chorioretinitis

A 56-year-old Hispanic male with past medical history of gout presented to the emergency room with a “purple spot” in his right eye for the last four days. Examination was significant for best corrected visual acuity (BCVA) 20/70, no anterior chamber reaction or vitreous cells, and a yellowish retinal lesion. Fluorescein angiography demonstrated mottled staining most pronounced in the inferior fovea. OCT demonstrated EZ disruption with RPE irregularities. Labs were significant for reactive fluorescent treponemal antibody absorption (FTA-Abs) and rapid plasma reagin (RPR) tests. The patient improved with 14 days of intravenous penicillin treatment with improvement of his ocular lesion and improvement of his BCVA to 20/25.

Presentation Date: 08/27/2020

Issue Date: 02/05/2021