Surgical repair of an inflammatory macular hole associated with ocular syphilis

PURPOSE: To describe a case of an inflammatory macular hole associated with ocular syphilis and its successful surgical closure. OBSERVATIONS: A 55-year-old man presented with count fingers vision and was found to have unilateral ocular syphilis with panuveitis and a foveal subretinal lesion. The inflammation quickly resolved with treatment, but he developed a full-thickness macular hole on day 5. A pars plana vitrectomy with membrane peel and intraocular gas was performed three months later. The macular hole was successfully closed, and the patient's vision improved to 20/200 18 months after repair. Foveal outer retinal atrophy limited final vision improvement. CONCLUSIONS AND IMPORTANCE: Ocular syphilis can rarely be associated with inflammatory macular holes. Surgical intervention can offer successful anatomic results; however, final visual outcomes may be limited by retinal scarring or atrophy from the original inflammation.