Abstract

A 32yr old male presented with gradual decrease in vision in day&night for a month without inflammation.OCT had generalised loss of photoreceptors&stippled hyperautofluorescence on FAF.Patient was tested&found HIV&syphilis +ve.Patient defered any form of treatment &at 3 weeks from presentation there was improvement in symptoms with complete restoration of photoreceptor layer.This pattern of symptoms & signs recurred subsequentlly 2 times one year apart with spontaneous recovery of symptoms&restoration of photoreceptors without any treatment.In 4th episode patient developed a round area of placoid retinitis in posterior pole with well defined hyperautofluorescence of FAF and localised loss of photoreceptors presenting as acute syphilitic posterior placoid retinopathy leading to definitive diagnosis.
Conclusion:Case highlights the importance of testing for the masquerade syphilis in patients presenting with recurrent photoreceptor loss & spontaneous resolution and multiple recurrences