Superficial retinal precipitates in patients with syphilitic retinitis.
OBJECTIVE
The purpose of this study was to describe the occurrence of superficial retinal precipitates in patients with syphilitic retinitis.


METHODS
This was a retrospective, observational case series of nine eyes of eight patients with syphilitic retinitis associated with superficial retinal precipitates. The clinical, photographic, angiographic, and laboratory records were reviewed. Characteristics and treatment response of these superficial retinal precipitates were observed.


RESULTS
All patients were Caucasian men, including 5 men who have sex with men (62.5%) and 6 (75.0%) who were positive for human immunodeficiency virus. None of the patients were previously diagnosed with syphilis. All patients developed panuveitis and a distinctly diaphanous or ground-glass retinitis associated with creamy yellow superficial retinal precipitates. In 3 patients (37.5%), the retinitis had a distinctive wedge-shaped appearance. Five patients (62.5%) had associated retinal vasculitis, 3 (37.5%) had serous retinal detachment, 2 (22.2%) had intraretinal hemorrhage, and 2 (22.2%) had papillitis. Within 2 weeks of initiating intravenous penicillin treatment, 7 patients (87.5%) experienced visual recovery to >or= 20/40. All affected eyes showed rapid resolution of clinical signs with minimal alternations of the retinal pigment epithelium in areas of prior retinitis after completion of antibiotic therapy.


CONCLUSIONS
Characteristic superficial retinal precipitates may occur over areas of syphilitic retinitis. Improved recognition of this highly suggestive clinical sign may aid in early diagnosis and treatment.
Fu
Evelyn X
EX
San Francisco Retina Foundation, San Francisco, California, USA.
Geraets
Ryan L
RL
Dodds
Emilio M
EM
Echandi
Laura V
LV
Colombero
Daniel
D
McDonald
H Richard
HR
Jumper
J Michael
JM
Cunningham
Emmett T
ET
D000328:Adult; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006679:HIV Seropositivity / Q000175:diagnosis; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use; D012160:Retina / Q000473:pathology*; D012173:Retinitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013588:Syphilis Serodiagnosis; D014792:Visual Acuity; D044465:White People
D010400:Penicillin G