A 56-year-old man presented with 20/400 vision in the right eye. Ophthalmoscopy revealed deep retinal punctate mottling extending temporally (Fig 1, left). En face optical coherence tomography (OCT) demonstrated corresponding hyperreflective dots at the level of the outer retina (Fig 1, top right). Serologic testing confirmed a diagnosis of active syphilitic chorioretinitis. The patient received intravenous penicillin for 7 days. On 1 week follow-up vision had improved to 20/30 with en face outer retinal OCT revealing disappearance of the hyperreflective dots (Fig 1, bottom right).


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