Indocyanine green angiography anomalies in ocular syphilis

Objective: to report indocyanine green (ICG) angiography anomalies in ocular syphilis. Design: interventional non-comparative case series. Participants: eight patients (16 eyes) affected by ocular syphilis. Methods: from January 1994 to October 2001, all patients presenting with a diagnosis of active ocular syphilis were evaluated by a standard fluorescein and ICG angiographic protocol. The ICG angiography was repeated after completion of a systemic antitreponemal and antinflammatory treatment. Results: ICG angiography anomalies were detected in 12/16 eyes (75%). Two types of anomalies have been observed: a) late phase scattered hyperfluorescent spots (11 eyes), b) a persistent staining of retinal vessels (1 eye). In 4 of these 12 eyes no alteration was recordable at the concomitant fluorescein angiography. When ICG angiography was repeated (5 ± 1 week after the beginning of treatment), the mentioned ICG anomalies disappeared. Conclusions: ICG angiography might be valuable when assessing patients with active ocular syphilis. First, it can disclose retinal and choroidal vascular anomalies that are not detectable by funduscopy and/or fluorescein angiography. Second, it can be useful to monitor the efficacy of antitreponemal therapy.