A Case of Optic Perineuritis Associated with Seronegative Neurosyphilis

Abstract

Optic perineuritis is characterized by optic disc swelling with normal visual acuity, pupillary responses and intracranial pressures, and normal visual fields except for an enlarged blind spot that may be confused with papilledema caused by brain tumor or pseudotumor cerebri. It is a rare manifestation of neurosyphilis, and it is thought to represent an extension of basal meningeal inflammation to the optic nerve sheaths. Serum VDRL tests are negative in a significant proportion of patients with late syphilis, particularly in those with neurosyphilis (seronegative syphilis). We present a case of optic perineuritis associated with seronegative neurosyphilis.