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March 2015

Asymptomatic Retinal Gumma

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky

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JAMA Ophthalmol. 2015;133(3):355-357. doi:10.1001/jamaophthalmol.2014.5232

Ocular syphilis, caused by the spirochete Treponema pallidum, presents a diagnostic dilemma because of the myriad ways in which it can appear. Anterior scleritis, uveitis involving any portion of the uveal tract, retinitis, retinal vasculitis, optic neuritis, diffuse retinal edema, exudative retinal detachment, and acute syphilitic posterior placoid chorioretinitis have all been described with varying degrees of regularity.13 Gummata, or luetic granulomas, result from tertiary syphilis. They are most commonly found in the liver but can be found in other organs. They are formed by local reactions to spirochetes after the immune system fails to kill them. Herein, we describe a case of an asymptomatic retinal gumma without active intraocular inflammation.

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