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KMID : 1151620160010020101
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Journal of Retina
2016 Volume.1 No. 2 p.101 ~ p.104
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Syphilitic Optic Neuritis Initially Misdiagnosed as Ischemic Optic Neuropathy
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Yi Ro-Woon
Kim Tai-Kyong
Lee Mee-Yon
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Abstract
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Purpose: To report a syphilitic optic neuritis case, initially misdiagnosed as arteritic ischemic optic neuropathy (AION), in which prior transient posterior placoid chorioretinitis was an important clue to the correct diagnosis.
Case summary: A 50-year-old man presented with blurry vision in the right eye. Funduscopy revealed optic disc swelling. Due to an elevated erythrocyte sedimentation ratio and C-reactive protein, our initial impression was AION. However, the diagnosis was corrected after reviewing a previous fundus photo revealing a large, pale yellow placoid lesion in the macula of the right eye. Serological examinations revealed confirmed syphilis infection. After a 2-week treatment with penicillin G, visual symptoms and signs fully resolved.
Conclusions: Optic neuropathy with an elevated erythrocyte sedimentation ratio and C-reactive protein should prompt suspicion for syphilitic optic neuritis. Misdiagnosis as AION could lead to steroid therapy without antibiotics, which can worsen prognosis.
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KEYWORD
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Acute syphilitic posterior placoid chorioretinitis, Ischemic optic neuropathy, Ocular syphilis, Optic neuritis, Syphilitic optic neuritis
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