Retinitis after Long-Term Corticosteroid Use

Abstract

A 61-year-old man presented with acute-onset blurriness in both eyes (OU). His medical history was significant for biopsy-negative temporal arteritis and long-term systemic corticosteroid use. On presentation, visual acuity was 20/40 with 3-4+ cells in the anterior chamber and 1+ cells in the vitreous OU. Fundus examination revealed elevated optic nerve margins and peripheral retinal whitening (Fig A). Laboratory work-up showed positive syphilis serology and elevated rapid plasma reagin 1:512. With the diagnosis of neurosyphilis the patient received intravenous penicillin, and vision improved to 20/20 with resolution of retinitis (Fig B).