Case Report
Volume 13 Issue 2 - 2022
Central Scotoma with no Apparent Abnormalities on Fundscopy - Case Report of Placoid Neuroretinitis Mimicking Retrobulbar Neuritis
Pedro Trés Vieira Gomes1*, Paulo Tadeu Silva Campos1, Julia Pontes Sousa1, Davi Trés Vieira Gomes2, Isabela Rita de Carvalho Cunha3, Natanael de Abreu Sousa3, Leticia Rosa Ribeiro Cunha4 and Kamilla Serqueira de Oliveira1
1Ophtalmology Resident in Hospital Oftalmológico de Brasília, Brasília, DF, Brazil
2Medical Student in Escola de Ciências Médicas da Santa Casa de Vitória, Vitória, ES, Brazil
3Strabismus, Neurophthalmology and Ophtalmopediatry Preceptor in Hospital Oftalmológico de Brasília, Brasília, DF, Brazil
4Strabismus and Ophtalmopediatry Department, Hospital Oftalmológico de Brasília, Brazil
*Corresponding Author: Pedro Trés Vieira Gomes, Ophtalmology Resident in Hospital Oftalmológico de Brasília, Brasília, DF, Brazil.
Received: December 07, 2021; Published: January 31, 2022


Patients presenting with low visual acuity (BAV) of acute installation, associated or not with field defects, without apparent fundoscopic changes, are labeled as possible carriers of retrobulbar optic neuritis. However, before starting a neurological investigation, some data from anamnesis and clinical examination are essential for the differential diagnosis with subclinical retinopathies (occult maculopathy).

This clinical report presents the case of a patient complaining of sequential bilateral central scotoma, with no apparent alteration in the background biomicroscopy, in which, due to some subtle clinical characteristics, it was possible to get rid of the diagnostic trap, which pointed to demyelinating retrobulbar neuritis.

Through the multimodal analysis of the retina, associated with other complementary exams, it was possible to identify that it was an infectious placoid neuroretinitis caused by syphilis.

The case presented here demonstrates the importance of delving into the signs and symptoms associated with low painless visual acuity or the presentation of central scotomas, in a patient with apparently normal fundoscopy. In the absence of a relative afferent defect and in the presence of positive visual symptoms (photopsia), it should be borne in mind that the most likely location remains the retina, ruling out the possibility of retrobulbar neuritis.

Keywords: Scotoma; Visual Acuity; Posterior Uveitis; Acute Posterior Multifocal Placental Pigment Epitheliopathy; Neurosyphilis


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Citation: Pedro Trés Vieira Gomes., et al. “Central Scotoma with no Apparent Abnormalities on Fundscopy - Case Report of Placoid Neuroretinitis Mimicking Retrobulbar Neuritis”. EC Ophthalmology 13.2 (2022): 50-55.

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