Ping‑Feng Tsaia, Chi‑Ting Horngb, Ming‑Ling Tsaia,c,d*
aDepartment of Medicine, National Defense Medical Center, Taipei, Taiwan, bDepartment of Ophthalmology, Fooyin University Hospital, Pingtung, Taiwan, cDepartment of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan, dSchool of Medicine, Tzu Chi University, Hualien, Taiwan
Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
A 31‑year‑old male with HIV infection visited our outpatient department because he had suffered from blurred vision in the left eye (LE) for 2 days. On examination, the best‑corrected visual acuity (BCVA) was 6/6 in the right eye and no light perception (NLP) in the LE. The slit lamp showed no specific findings. Fundoscopic examination revealed papillitis and small multifocal grayish yellow lesions located mostly in the postequatorial fundus [Figure 1a]. After 2 days, these grayish yellow lesions became confluent, and a large grayish plaque‑like chorioretinal lesion with typical placoid edges was observed at the posterior pole [Figure 1b]. Laboratory studies showed positive Treponema pallidum hemagglutination (TPHA; 1:1280). Under the impression of acute syphilitic posterior placoid chorioretinopathy (ASPPC) with papillitis, penicillin was administrated intravenously. Two weeks after treatment, the confluent grayish placoid lesion was resolved, and multiple yellowish subretinal lesions developed [Figure 1c]. Four weeks after treatment, these yellowish subretinal lesions diminished, and papillitis improved [Figure 1d]. However, the BCVA remained NLP in the LE.
