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Submitted: 2023-06-25
DOI: 10.35119/myjo.v7i2.387
Case Reports
Published: 2026-01-20

Posterior placoid chorioretinitis: a disguise of ocular syphilis

UM Eye Research Centre (UMERC), Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
UM Eye Research Centre (UMERC), Department of Ophthalmology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
Department of Ophthalmology, Hospital Shah Alam, Shah Alam, Malaysia
chorioretinitis education placoid lesion syphilis

Abstract

Background: To report a case of ocular syphilis presenting as acute syphilitic posterior placoid chorioretinitis.

Case presentation: A 38-year-old male presented with reduced vision in the left eye for 2 weeks. Best-corrected Snellen visual acuity was 6/60 in the affected eye and 6/9 contralaterally. Fundoscopy revealed mild vitritis, hyperaemic optic disc, a yellowish placoid lesion at the macula, and choroiditis. Optical coherence tomography of the macula showed disruption at the outer retinal layers and hyperreflective lesions in the choriocapillaris. Fundus fluorescein angiography showed a “hot” disc and patches of vasculitis. The diagnosis was delayed by spontaneous clinical resolution and false negative non-treponemal test due to the prozone phenomenon. Due to high clinical suspicion, the test was repeated with a diluted serum sample that turned out to be positive and was treated with intravenous benzylpenicillin.

Conclusion: A placoid lesion at the macula should raise high suspicion of ocular syphilis.