부산대학교 도서관

Purpose Acute syphilitic posterior placoid chorioretinitis (ASPPC) is a rare clinical manifestation of ocular syphilis. The cause of the placoid lesion is still up for debate but could be caused by an impaired choriocapillaris perfusion. However, less attention has been paid to the hypofluorescence of the plaque on late-phase indocyanine green angiography (ICGA). The aim of this study was to comprehensively analyze multimodal imaging findings in patients with ASPPC and to highlight the value of ICGA for the diagnosis of ASPPC. Design Retrospective observational case study. Methods The medical records of patients with uveitis who consulted our tertiary center between 2012 and December 2015 were reviewed. Patients who were diagnosed with uveitis related to syphilis infection with posterior placoid lesions seen on multimodal imaging were included. We compared the aspect of ASPPC on fundus color photography, blue autofluorescence, fluorescein angiography, optical coherence tomography, and early-, mid- and late-phase ICGA. Results Fifteen eyes of 12 patients were included in the study. Hypofluorescent plaques were seen on late-phase ICGA in all eyes, corresponding to the placoid lesions visible on blue autofluorescence, while the choriocapillaris filling was normal on fluorescein angiography and ICGA. Within the plaques, optical coherence tomography showed ellipsoid zone disruptions, outer retinal disruptions, and retinal pigment epithelium granulations. Conclusion ASPPC could be caused by retinal pigment epithelium dysfunction secondary to an infectious or inflammatory disorder, characterized by a hypofluorescence visible only on late-phase ICGA, and resulting in photoreceptor disruptions. The RPE impairment was reversible after prompt antibiotic treatment. Author Affiliation: (a) From the Centre Hospitalier National des Quinze-Vingts (J.V., M-H.E., J-A.S., S.M.), DHU Sight Restore, Paris (b) Ophthalmology Department (A.G.), Université de Paris, APHP, Hôpital Lariboisière, Paris, France (c) Department of Ophthalmology (M-H.E., J-A.S.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA * Inquiries to Sarah Mrejen, Centre Hospitalier National des Quinze-Vingts, 28 rue de Charenton, 75012 Paris, France. Article History: Received 5 August 2021; Revised 3 February 2022; Accepted 4 February 2022 Byline: Jérémie Villaret (a), Marie-Hélène Errera (a,c), José-Alain Sahel (a,c), Alain Gaudric (b), Sarah Mrejen [smrejen@15-20.fr] (a,*), Michel Paques (a)