Figure 9.

Bilateral optic neuropathy in neurosyphilis.

A 34-year-old man experienced subacute, progressive visual loss. In 3 months he became blind in his right eye and his left vision became blurred, combined with a visual field defect. The orbit MRI revealed a diffuse T2 HSI in the right optic nerve (arrow) and also moderate T2 HSI in the left optic nerve (arrow head) (A and B). The cerebrospinal fluid revealed pleocytosis, increased level of protein, positive venereal disease research laboratory (VDRL), and fluorescent treponemal antibody absorption (FTA-ABS) test results. After treatment with intravenous penicillin, his constricted visual field in the left eye, which represented a pattern of perineuritis (C) improved over one month (D).

A and B = T2-weighted image, C and D = Humphrey perimetry.

HSI, high signal intensity.