Angiographic patterns in ocular syphilis

Abstract

Abstract Purpose To describe angiographic patterns encountered in the context of ocular syphilis and to offer statistical associations between specific angiographic manifestations and severity of disease presentation as well as disease evolution after treatment. Methods We retrospectively reviewed the Fluorescein and ICG angiograms of 23 patients with ocular syphilis presented to the Uveitis clinic of the Jules‐Gonin Eye Hospital. FA and ICGA were performed following a standard protocol for posterior uveitis. Patterns of fluorescence were noted and subsequently statistical associations between each angiographic pattern and any demographic, clinical or laboratory parameter at baseline and after treatment were sought. Results Vasculitis in fluroangiography exhibited a statistically significant association with vitritis (p=0.020) and a borderline association with macular oedema (p=0.086). Disc hyperfluorescence in fluroangiography was significantly associated with seropositivity for HIV infection (p=0.012). The presence of any Dark Dots in ICGA significantly correlated with anterior uveitis (p=0.013) and marginally with vitritis (p=0.034) and relapse of inflammation after proper antibiotic treatment (p=0.066). An important association between the presence of Hot Spots on ICGA and longer duration of symptoms prior to initial visit was also identified (p=0.007). Conclusion Out of the several associations identified implicating specific angiographic features, we underline the possible predictive value of the presence of any Dark Dots in ICGA for future relapse of inflammation after treatment and the role of Hot Spots in ICGA as markers of long‐standing disease.