Syphilis Retinitis

This patient is a 40 year old male with a history of HIV infection. He presented with symptoms of headaches, blurred vision and floaters. At his initial visit his vision was 20/100 in his right eye and 20/200 in his left. Optical coherence tomography images shows bilateral outer retinitis that is consistent with syphilis infection. Disruptions of ellipsoid zone in both eyes are indicated with a green arrows. Inflamed cells are noticeable appearing as blurred areas or nodules in both right and left eyes (red arrows). Intravitreal fluorescein angiography reveals hyperfluorescent posterior placoid chorioretinopathy in both eyes due to leakage (blue arrows). He was treated with 10 million units of intravenous Penicillin G for 10 days. After treatment his vision improved to 20/20 in the right eye and 20/40 in the left.