Acute Macular Neuroretinopathy in a Patient with Syphilis: Case Report
10.21561/jor.2025.10.1.79
- Author:
Seung Wan NAM
- Publication Type:CASE REPORT
- From:
Journal of Retina
2025;10(1):79-83
- CountryRepublic of Korea
- Language:English
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Abstract:
Purpose:To report a case of acute macular neuroretinopathy (AMN) in a patient with syphilis.Case summary: A 52-year-old female visited our clinic due to decreased vision in the left eye for two weeks. She had been diagnosed with latent syphilis one month prior and had received penicillin G treatment. At the initial visit, her best corrected visual acuity (BCVA) was 2/20 (0.1) in the left eye. A fundus examination did not show any significant abnormalities in the left eye, but a near-infrared (NIR) image showed dark gray, petaloid, perifoveal lesions with the tips pointed toward the fovea in the left eye. Optical coherence tomography (OCT) images showed focal ellipsoid zone disruptions in the left eye. OCT angiography images showed capillary dropout in the deep capillary plexus of the retina, corresponding to AMN lesions in the left eye. Fluorescein angiography and indocyanine green angiography showed no significant change in the left eye. Humphrey visual fields revealed paracentral depressions in the left eye. During the follow-up period, NIR and OCT at one week, one month, and two months after diagnosis showed regression of the initial hyper-reflectivity of the outer retina to thin the outer retina in the left eye. Her BCVA (2/20 (0.1)) was not improved at the two-month follow-up visit.
Conclusions:This case is the first report in Korea of AMN in a patient with syphilis. Clinicians should be aware of the risk of AMN in patients with a history of syphilis who complain of eye symptoms.
