Karen M Wai1, Dan Gong1, Marianeli Rodriguez2, Emmett T Cunningham3,4,5, Demetrios G Vavvas1, Dean Eliott1. 1. Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA. 2. Vitreo-Retinal Associates of Worcester, PC, Worcester, MA, USA. 3. The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA. 4. The Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA. 5. The Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.
Abstract
Purpose: We describe the development and management of choroidal neovascularization (CNV) in a patient with acute syphilitic posterior placoid chorioretinitis (ASPPC). Methods: A retrospective case review is presented. Results: A 66-year-old man presented with unilateral blurry vision. He had a history of systemic syphilis infection twice, the last diagnosed 15 years before presentation and treated with intravenous ceftriaxone, resulting in seroreversion of an initially positive rapid plasma reagin (RPR). Examination revealed ASPPC with subfoveal CNV. Repeat testing revealed an RPR titer of 1:16 384. He was treated with 6 monthly intravitreal injections of bevacizumab and systemic antibiotics, resulting in resolution of his ASPPC and regression of his CNV. Conclusions: CNV is a rare complication of ASPPC. Multimodal imaging can be useful to suggest the diagnosis, and prompt treatment with systemic antibiotics and intravitreal anti-vascular endothelial growth factor agents can lead to resolution of ASPPC and regression of CNV, respectively.
Purpose: We describe the development and management of choroidal neovascularization (CNV) in a patient with acute syphilitic posterior placoid chorioretinitis (ASPPC). Methods: A retrospective case review is presented. Results: A 66-year-old man presented with unilateral blurry vision. He had a history of systemic syphilis infection twice, the last diagnosed 15 years before presentation and treated with intravenous ceftriaxone, resulting in seroreversion of an initially positive rapid plasma reagin (RPR). Examination revealed ASPPC with subfoveal CNV. Repeat testing revealed an RPR titer of 1:16 384. He was treated with 6 monthly intravitreal injections of bevacizumab and systemic antibiotics, resulting in resolution of his ASPPC and regression of his CNV. Conclusions: CNV is a rare complication of ASPPC. Multimodal imaging can be useful to suggest the diagnosis, and prompt treatment with systemic antibiotics and intravitreal anti-vascular endothelial growth factor agents can lead to resolution of ASPPC and regression of CNV, respectively.
Authors: Sara E Oliver; Mark Aubin; Leah Atwell; James Matthias; Anna Cope; Victoria Mobley; Alexandra Goode; Sydney Minnerly; Juliet Stoltey; Heidi M Bauer; Robin R Hennessy; Dawne DiOrio; Robyn Neblett Fanfair; Thomas A Peterman; Lauri Markowitz Journal: MMWR Morb Mortal Wkly Rep Date: 2016-11-04 Impact factor: 17.586
Authors: Ahmadreza Moradi; Sherveen Salek; Ebenezer Daniel; Sapna Gangaputra; Trucian A Ostheimer; Bryn M Burkholder; Theresa G Leung; Nicholas J Butler; James P Dunn; Jennifer E Thorne Journal: Am J Ophthalmol Date: 2014-11-05 Impact factor: 5.258