EN FACE DEPTH-RESOLVED OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY MONITORING OF MACULAR OUTER RETINAL DEPOSITS IN A CASE OF MULTIFOCAL CHOROIDITIS MIMICKING SYPHILITIC UVEITIS.

Purpose: Multifocal choroiditis is a rare inflammatory condition characterized by retinal and choroidal lesions that may present similarly to ocular pathology of various etiologies. Here, we present a case of multifocal choroiditis mimicking syphilitic uveitis with unique en face optical coherence tomography angiography imaging characteristics.

Methods: This was a case report.

Results: A 61-year-old woman presented with blurry vision, floaters, and multiple whitish subretinal deposits on en face swept-source optical coherence tomography angiography in the left eye. Fluorescent treponemal antibody test absorption was positive, which led to the initial diagnosis of syphilitic uveitis and subsequent treatment with IV penicillin. During follow-up, optical coherence tomography angiography of the left eye revealed the development of a new choroidal neovascular membrane and new punched-out lesions in the posterior pole. The patient was eventually diagnosed with multifocal choroiditis and treated with aflibercept injections.

Conclusion: Immune-mediated uveitis can simulate infectious and neoplastic uveitis. En face optical coherence tomography angiography is a unique imaging modality that allowed for the complete characterization and monitoring of the submacular deposits. This expands the clinical spectrum of multifocal choroiditis.