International Ophthalmology

, Volume 33, Issue 2, pp 159–162 | Cite as

Peripapillary choroidal neovascularisation in the context of ocular syphilis is sensitive to combination antibiotic and corticosteroid treatment

  • Konstantinos BalaskasEmail author
  • Stephen Spencer
  • Yvonne D’Souza
Case Report


Peripapillary choroidal neovascularisation (CNV) in the context of ocular syphilis is exceptional and little is known about its natural history and optimal therapeutic management. We report here a case of right eye peripapillary CNV with subretinal fluid encroaching on the fovea in a patient with mild bilateral ocular inflammation and cystoid macular oedema (CMO) in his contralateral eye. Extensive investigations revealed positive serology for active syphilitic infection. The patient received treatment with intravenous benzylpenicillin according to the algorithm for neurosyphilis complemented with oral corticosteroids as prophylaxis against Jarisch-Herxsheimer reaction for a period of 17 days. On the 15th day, receding of subretinal fluid in his right eye to a small pocket around the optic disc was identified as well as resolution of left eye CMO. We suggest that a course of antibiotic treatment for neurosyphilis with the addition of oral corticosteroids may be an effective therapeutic option for CNV in the context of ocular syphilis and thus more invasive treatment approaches are not warranted.


Ocular syphilis Choroidal neovascularisation Treatment 


Conflict of interest

Y.D.S. has received travel grants from Novartis and Allergan and been on the advisory board. No financial or proprietary interests exist for any author. The authors report no conflicts of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Konstantinos Balaskas
    • 1
    • 3
    Email author
  • Stephen Spencer
    • 2
  • Yvonne D’Souza
    • 1
  1. 1.Manchester Royal Eye Hospital, Central Manchester Healthcare Foundation TrustManchesterUK
  2. 2.Calderdale and Huddersfield NHS TrustHalifaxUK
  3. 3.Moorfields Eye HospitalLondonUK

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