Not so slowly progressive visual loss

A 51-year-old man presented with bilateral progressive visual loss during a 2-month period. Visual acuity was 20/60 in both eyes with bilateral constr icted visual fields. Funduscopy revealed bilateral disk pallor and arteriol ar attenuation. His vision declined rapidly during the next 2 weeks. Invest igations showed a positive cerebrospinal fluid Venereal Disease Research La boratory test (1:8). A diagnosis of neurosyphilis was made, and treatment w as started with high-dose intravenous and intramuscular penicillin. (C) 199 9 by Elsevier Science Inc. All rights reserved.