TY - JOUR
T1 - Descolamento de retina exsudativo bilateral associado a alterações de comportamento em paciente com diagnóstico de neurossífilis
T2 - Relato de caso
AU - Malerbi, Fernando Korn
AU - Ghanem, Ramon Coral
AU - Chiang, Jeane
AU - Takahashi, Walter Yukihiko
PY - 2006
Y1 - 2006
N2 - Purpose: To report a case of bilateral retinal detachment associated with behavior changes. Result: A 62-year-old, female patient presented agitated, complaining of progressive bilateral low vision for the 3 past months, along with anxiety and behavior changes. On examination, she had visual acuity of light perception in the right eye and conting fingers at 30 cm in the left eye; anterior chamber reaction; bilateral hyperemic and edematous optic disc and bilateral serous retinal detachment, yellow-white subretinal peripapillary plaques and subretinal and intraretinal exudation. On laboratory work-up, the patient had positive VDRL and FTA-Abs tests. Lumbar puncture was done; she had positive FTA-Abs and hemagglutination treponemal test on spinal fluid analysis. Neurosyphilis diagnosis was established, and the patient was admitted to the hospital for an intravenous penicillin course associated with oral prednisone (0.5 mg/kg). After 2 weeks, the patient showed marked improvement of her retinal findings, with reatachment of the retina and also an improvement of visual acuity. Conclusion: Syphilis is a pleomorphical disease, and may present as diffuse uveitis associated with bilateral exudative retinal detachment. Central nervous system involvement must always be evaluated and discarded; proper treatment may lead to visual function improvement and diminished sequelae.
AB - Purpose: To report a case of bilateral retinal detachment associated with behavior changes. Result: A 62-year-old, female patient presented agitated, complaining of progressive bilateral low vision for the 3 past months, along with anxiety and behavior changes. On examination, she had visual acuity of light perception in the right eye and conting fingers at 30 cm in the left eye; anterior chamber reaction; bilateral hyperemic and edematous optic disc and bilateral serous retinal detachment, yellow-white subretinal peripapillary plaques and subretinal and intraretinal exudation. On laboratory work-up, the patient had positive VDRL and FTA-Abs tests. Lumbar puncture was done; she had positive FTA-Abs and hemagglutination treponemal test on spinal fluid analysis. Neurosyphilis diagnosis was established, and the patient was admitted to the hospital for an intravenous penicillin course associated with oral prednisone (0.5 mg/kg). After 2 weeks, the patient showed marked improvement of her retinal findings, with reatachment of the retina and also an improvement of visual acuity. Conclusion: Syphilis is a pleomorphical disease, and may present as diffuse uveitis associated with bilateral exudative retinal detachment. Central nervous system involvement must always be evaluated and discarded; proper treatment may lead to visual function improvement and diminished sequelae.
KW - False positive reactions
KW - Neurobehavioral manifestations
KW - Prednisone/therapeutic use
KW - Retinal detachment
KW - Syphilis serodiagnosis
KW - Syphilis/diagnosis
KW - Syphilis/drug therapy
KW - Uveitis
UR - http://www.scopus.com/inward/record.url?scp=33746349799&partnerID=8YFLogxK
U2 - 10.1590/s0004-27492006000100022
DO - 10.1590/s0004-27492006000100022
M3 - Artículo
SN - 0004-2749
VL - 69
SP - 115
EP - 118
JO - Arquivos Brasileiros de Oftalmologia
JF - Arquivos Brasileiros de Oftalmologia
IS - 1
ER -