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Syphilitic Panuveitis and Rhegmatogenous Retinal Detachment: Diagnostic Pitfalls and Treatment Considerations.

Sofija Davidović Terzić1,2, Siniša Babović2, Svetlana Pavin2

  • 1Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.

Medicina (Kaunas, Lithuania)
|May 4, 2026
PubMed
Summary

Syphilitic panuveitis, a severe eye condition, can mimic other uveitis types and lead to vision loss. Early syphilis and HIV testing is crucial for diagnosis and preventing complications like retinal detachment.

Keywords:
masquerade syndromeocular syphilispanuveitisposterior uveitisretinal detachmentvitreoretinal interface

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Rheumatology

Background:

  • Syphilitic panuveitis presents diagnostic challenges due to its mimicry of noninfectious/viral uveitis.
  • Posterior segment involvement is common, leading to vitritis, vasculitis, and optic neuropathy.
  • Rhegmatogenous retinal detachment (RRD) is a rare but severe complication indicating advanced inflammation.

Purpose of the Study:

  • To review the clinical presentation, pathophysiology, and management of syphilitic panuveitis and associated RRD.
  • To highlight diagnostic pitfalls, including West Nile virus (WNV) mimicry.
  • To emphasize the importance of early diagnosis and appropriate treatment.

Main Methods:

  • A narrative literature review was conducted.
  • Databases searched included PubMed, Scopus, and Web of Science (January 2000–September 2025).
  • Studies on syphilitic panuveitis, RRD, and infectious mimics were analyzed qualitatively.

Main Results:

  • Syphilitic panuveitis often involves the posterior segment, presenting with vitritis, retinal vasculitis, and optic neuropathy.
  • RRD in syphilitic panuveitis results from inflammation-induced damage, complicating surgical outcomes.
  • HIV coinfection can alter disease presentation; WNV is a key mimicker.

Conclusions:

  • Early consideration of syphilitic panuveitis is vital for unexplained posterior uveitis.
  • Routine syphilis and HIV testing, alongside evaluation for mimics like WNV, is essential.
  • RRD signifies severe vitreoretinal damage, necessitating prompt antimicrobial therapy and surgical intervention.