A 29-year-old sexually active man presents with bilateral panuveitis, patchy retinal vasculitis, and a macular lesion described as acute syphilitic posterior placoid chorioretinitis. Which test confirms the diagnosis?
- A Aqueous tap polymerase chain reaction for treponemal DNA in all cases before starting therapy
- B Serum fluorescent treponemal antibody test alone without any non-treponemal test
- C Non-treponemal test such as VDRL confirmed by treponemal-specific test such as FTA-ABS ✓
- D Skin biopsy showing plasma cell infiltration
Correct answer: C. Non-treponemal test such as VDRL confirmed by treponemal-specific test such as FTA-ABS
Explanation
Syphilitic uveitis is diagnosed serologically using a non-treponemal screening test (VDRL or RPR) followed by a confirmatory treponemal-specific test (FTA-ABS or TPHA); both together define current or past infection. Treponemal tests stay positive for life after treated infection, so they cannot be used alone to judge activity. Aqueous PCR is reserved for atypical cases, and skin biopsy plays no routine role in ocular syphilis.
Reference: Yanoff and Duker Ophthalmology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.