Syphilitic Retinal Detachment and Uveal Effusion

A 32-year-old man developed a recurrent nonrhegmatogenous retinal detachment, uveal effusion, and visual loss as a result of latent secondary syphilis. Treponemes were found in the subretinal fluid and the Treponema pallidum hemagglutination test demonstrated substantially higher titers in the subretinal fluid than in the serum (1:2,560 vs 1:16). Despite scleral dissection and a scleral implant and treatment with penicillin, the patient's visual loss persisted and the last examination showed a thickened choroid, a flat nonrhegmatogenous retinal detachment, and reaccumulation of subretinal fluid.