Topical corticosteroid was effective for cystoid macular edema in a case of syphilitic retinochoroiditis

Purpose: To report a case of syphilitic retinochoroiditis with cystoid macular edema that responded to topical corticosteroid. Case: A 59-year-old male presented with impaired vision in the left eye since 9 months before. He had been treated for syphilis during puberty. Findings: Corrected visual acuity was 1.0 right and 0.2 left. The left eye showed diffuse vitreous opacity with cystoid macular edema. He showed high value for TPHA, leading to the diagnosis of syphilic retinochoroiditis. Left visual acuity improved to 0.6 after daily infusion of penicillin G. The residual macular edema was treated by subtenon injection of triamcinolone acetonide. Left visual acuity improved to 0.9. There has been no recurrence for 20 months until present. Conclusion: Response to topical corticosteroid in the present case suggests that immune-related inflammation may have been present in the pathogenesis of cystoid macular edema.