Purpose: To describe the appearance and resolution of a vascularized iris nodule in a case of ocular syphilis with swept-source anterior segment optical coherence tomography (SS AS-OCT) imaging.
Methods: Case report.
Results: A 73-year-old male with a history of ocular syphilis presented with anterior uveitis of the left eye characterized by mutton fat keratic precipitates, anterior chamber cells, hypopyon mixed with hemorrhage, and a vascularized iris nodule. SS AS-OCT similarly showed keratic precipitates, anterior chamber cells, and an iris lesion with anterior hyperreflectivity and shadowing. Systemic workup revealed a new syphilis infection with rapid plasma reagin (RPR) titer of 1:512. After completing a 14-day course of intravenous penicillin and topical steroid treatment, there was resolution of these ocular findings.
Conclusion: Ocular syphilis should be considered on the differential diagnosis for vascularized iris lesions. Our case demonstrates SS-AS-OCT findings in this rare presentation of ocular syphilis.
Keywords: Iris nodule; optical coherence tomography; syphilis; uveitis.