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A case of neuroretinitis in a patient with primary neurosyphilis Momoko Yamakawa 1 , Mami Kusaka 2 , Hogara Taguchi 3 , Masayuki Akimoto 2 1Department of Ophthalmology, Kitano Hospital 2Department of Ophthalmology, Osaka Red Cross Hospital 3Department of Ophthalmology, National Hospital Tochigi Hospial pp.497-502
Published Date 2019/4/15
DOI https://doi.org/10.11477/mf.1410213117
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Abstract Purpose:To report a case of stage 1 syphilis who showed unilateral optic disc swelling and serous retinal detachment as manifestation of early neurosyphilis.

Case:A 51-year-old male presented with impaired vision in his right eye. He had had sexual intimacy 3 months before.

Findings and Clinical Course:Corrected visual acuity was 0.9 right and 1.5 left. Critical flicker fusion frequency was 28 Hz in the right eye and 43 Hz in the left. Relative afferent pupillary defect was present in the right eye. Relative central scotoma was present in the right eye. The left eye was free of pathological findings. Blood test was strongly positive to syphilis. Cerebrospinal fluid was also strongly positive to syphilis. He showed ulcers in the genitals but showed otherwise no skin lesions. He was diagnosed with stage 1 syphilis and was treated by high-dose penicillin. Retinal detachment in the right eye disappeared on day 19 of treatment with improved visual acuity to 1.5.

Conclusion:Ocular involvement often takes place later than stage 2 syphilis. This case illustrates that acute neueroretinitis may occur in early phase of stage 1 syphilis.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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