RESUMO
Objective To observe the fundus imaging characteristics of different stages of syphilitic posterior uveitis. Methods Retrospective cases series. Forty-six eyes of 32 patients with syphilitic posterior uveitis were included. There were 14 patients (16 eyes) and 18 patients (30 eyes) were assigned to acute stage group (with the course<2 months) and chronic stage group (with the course≥2 months) respectively. All eyes received the examination of indirect ophthalmoscopy, color fundus photography, fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). All patients received regular anti-syphilitic treatment. Color fundus photography and OCT were followed after treatment. The fundus imaging characteristics of different stages of syphilitic posterior uveitis were observed. Results Indirect ophthalmoscopy and fundus color photography showed that in the acute stage group, there were 3/16 eyes with optic disc edema;4/16 eyes with a yellowish, placoid lesion involving the macular. There were only some pigment alterations on the fundus after treatment. In the chronic stage group, there were 4/30 eyes with optic disc hyperemia, 3/30 eyes with cystoid macular edema. After treatment, the optic hyperemia vanished gradually, but there were still some pigment alterations. The FFA images of two groups showed various vascular leakages. In the chronic stage group, patients also showed hyper-fluorescence with cystoid macular edema. The patients with course 2–3 years have more transmitted fluorescence on FFA. OCT showed that all eyes in the acute stage group had lost the ellipsoid zone, with irregular granular reflectivity of the retinal pigment epithelium (RPE) layer, 6 eyes with subretinal fluid in the macular. After treatment, the ellipsoid zone and RPE layer structure recovered gradually. In the chronic stage group, all eyes showed widespread loss of the ellipsoid zone, pigment migration and (or) cystoid macular edema. After treatment, the ellipsoid zone showed partial recovery. The outer ellipsoid zone was still discontinuous in patients with long duration. Conclusions Syphilitic posterior uveitis patients generally had normal fundus, but some cases had a yellowish, placoid lesion involving the macular. FFA showed various vascular leakages, and the chronic stage group showed more transmitted fluorescence. The major OCT change was loss of the ellipsoid zone or with subretinal fluid. After treatment, fundus showed no abnormal manifestations except some pigment alterations;the ellipsoid zone structure recovered gradually in acute stage eyes, partially recovered in chronic stage eyes.
RESUMO
Objective To observe the clinical characteristics and fundus imaging features of unilateral acute idiopathic maculopathy (UAIM).Methods Retrospective cases series.Six eyes of 6 patients with UAIM were included in this study.There were 4 males and 2 females.All patients underwent best corrected visual acuity (BCVA),fundus color photography,spectral domain optical coherence tomography (SD-OCT) and fundus fluorescein angiography (FFA) examinations.3 patients underwent indocyanine green angiography (ICGA) examination.No intervention was given in all patients after diagnosis.The mean follow-up was 6.3 months.BCVA,fundus color photography,SD-OCT and FFA were performed in follow-up.Results The ocular symptoms included unilateral sudden decreased vision,metamorphopsia and central scotoma.All patients had a yellow-white lesion involving the macular and irregular small bleeding was seen in 3 eyes.Irregular hyperfluorescence in macular area was seen in all patients,some with the hemorrhages showed blocked fluorescence at the early stage of FFA and fluorescence storage at the late stage.ICGA showed that hypo-fluorescence in macular area continually.SD-OCT showed that subretinal fluid in the macular and lost the ellipsoid zone.During the follow-up period,the subretinal fluid was absorbed spontaneously in one month.The ellipsoid zone structure recovered gradually and the visual acuity were normal.At the time of the latest follow-up,the BCVA was 0.8 in 4 eyes,1.0 in 2 eyes.Conclusions UAIM is featured with a unilateral,acute,transient and exudative lesion in the macular,which can be spontaneously resolved;It mainly affects outer retina.