Bilateral Panuveitis and Placoid Retinitis in Ocular Syphilis Complicated by Subsequent Retinal Detachment

Purpose: To report a case of ocular syphilis presenting as bilateral panuveitis complicated by retinal detachment in a patient with intravenous drug use. Methods: A single case was reviewed. Results: A 35-year-old woman presented with a 3-week history of redness, photophobia, vision loss, and floaters. Her medical history was significant for recent gonorrhea infection, prior methicillin-resistant Staphylococcus aureus and hepatitis C infections, and intravenous drug use. Ocular examination revealed severe anterior chamber inflammation, dense vitritis, and peripheral retinal whitening. The differential diagnosis included endogenous endophthalmitis and acute retinal necrosis. Syphilis serology returned reactive; however, the patient was lost to follow-up before completing treatment. She presented again 2 weeks later with a retinal detachment necessitating pars plana vitrectomy. Conclusions: Ocular syphilis may present as panuveitis or placoid retinitis, closely mimicking other infectious and inflammatory conditions, particularly in patients with overlapping risk factors. Early diagnosis and treatment are critical to prevent severe complications, such as retinal detachment.