We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Observation |

Asymptomatic Retinal Gumma

Douglas K. Sigford, MD1; Shlomit Schaal, MD, PhD1
[+] Author Affiliations
1Department of Ophthalmology and Visual Sciences, University of Louisville, Louisville, Kentucky
JAMA Ophthalmol. 2015;133(3):355-357. doi:10.1001/jamaophthalmol.2014.5232.
Text Size: A A A
Published online


Ocular syphilis, caused by the spirochete Treponema pallidum, presents a diagnostic dilemma because of the myriad ways in which it can appear. Anterior scleritis, uveitis involving any portion of the uveal tract, retinitis, retinal vasculitis, optic neuritis, diffuse retinal edema, exudative retinal detachment, and acute syphilitic posterior placoid chorioretinitis have all been described with varying degrees of regularity.13 Gummata, or luetic granulomas, result from tertiary syphilis. They are most commonly found in the liver but can be found in other organs. They are formed by local reactions to spirochetes after the immune system fails to kill them. Herein, we describe a case of an asymptomatic retinal gumma without active intraocular inflammation.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Figure 1.
Color Fundus Photograph, Fluorescein Angiograms, and Indocyanine Green Angiograms of the Right Eye on Presentation

A, Color fundus photograph shows neurosensory retinal detachment involving the fovea with an underlying poorly demarcated yellow/white lesion and small subretinal yellow lesions. B and D, Early-phase (B) and late-phase (D) fluorescein angiograms show patchy hyperfluorescence without vasculitis or leakage from the optic nerve. C and E, Early-phase (C) and late-phase (E) indocyanine green angiograms show deep hyperfluorescence without optic nerve edema.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Optical Coherence Tomography Through the Center of the Neurosensory Detachment

A, Optical coherence tomography on presentation demonstrates subretinal fluid, hyperreflective foci, and disrupted retinal pigment epithelium including ill-defined subretinal hyperreflectivity. B, Two weeks after treatment with intravenous penicillin. C, Three months after treatment. D, Six months after treatment.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections