Título / Title

OCULAR SYPHILIS: MULTIPLE FACES OF THE SAME DISEASE

Introdução / Purpose

Syphilis is an infectious disease with multisystemic involvement and may have several ocular manifestations, being able to simulate various conditions. It is important to know the different ophthalmological presentations of syphilis for a correct diagnosis and adequate treatment.

Material e Método / Methods

To present a case of posterior syphilitic placoid in both eyes.

Resultados / Results

A 27-year-old woman was admitted to the Department of Ophthalmology of UNICAMP, reporting a sudden reduction of visual acuity in the left eye, without pain, 2 days ago.
She reported a similar condition 1 year ago, being investigated in another service where received the diagnostic hypothesis of optic neuritis.
She did not mention epidemiological history or life habits that suggested any etiology.
BCVA 0.8/0.3. PIO 11/12.
Biomicroscopy without pathological findings. There was no relative afferent pupillary defect.
Fundoscopy showing 1+ vitreite, with regular contour optic disk, with multiple whitish confluent points at posterior pole and middle periphery.
Angiography evidenced early hypofluorescence in the form of a plaque in the posterior pole and periphery, with progressive staining in the late phases,
OCT with presence of hyperdensing points in external retinal layers in both eyes, with a higher concentration on the left.
From the suspicion of syphilis, the VDRL test was performed, which found the result titre 1: 128. After therapy with crystalline penicillin, patient progressed with improvement.

Discussão e Conclusões / Conclusion

Syphilis has three phases and the various ophthalmological findings can occur in any of them.
The placode format has the pathognomonic findings found by angiography.
On suspicion, it is essential to request specific serological tests and, after diagnostic confirmation, a broad approach to the possibility of other sexually transmitted diseases.
The recommended treatment is similar to that of neurosyphilis.

Palavras Chave

Ocular Syphilis, Sexually Transmitted Diseases

Area

CLINICAL RETINA