[Exudative bilateral retinal detachment and behavior changes in a patient with neurosyphilis: case report].
OBJECTIVE
To report a case of bilateral retinal detachment associated with behavior changes.


RESULTS
A 62-year-old, female patient presented agitated, complaining of progressive bilateral low vision for the 3 past months, along with anxiety and behavior changes. On examination, she had visual acuity of light perception in the right eye and conting fingers at 30 cm in the left eye; anterior chamber reaction; bilateral hyperemic and edematous optic disc and bilateral serous retinal detachment, yellow-white subretinal peripapillary plaques and subretinal and intraretinal exudation. On laboratory work-up, the patient had positive VDRL and FTA-Abs tests. Lumbar puncture was done; she had positive FTA-Abs and hemagglutination treponemal test on spinal fluid analysis. Neurosyphilis diagnosis was established, and the patient was admitted to the hospital for an intravenous penicillin course associated with oral prednisone (0.5 mg/kg). After 2 weeks, the patient showed marked improvement of her retinal findings, with reatachment of the retina and also an improvement of visual acuity.


CONCLUSIONS
Syphilis is a pleomorphical disease, and may present as diffuse uveitis associated with bilateral exudative retinal detachment. Central nervous system involvement must always be evaluated and discarded; proper treatment may lead to visual function improvement and diminished sequelae.
Departamento de Oftalmologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. femalerbi@terra.com.br
Fernando Korn
FK
Malerbi
Ramon Coral
RC
Ghanem
Jeane
J
Chiang
Walter Yukihiko
WY
Takahashi
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002825:Chorioretinitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008875:Middle Aged; D009494:Neurosyphilis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010406:Penicillins / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D012163:Retinal Detachment / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D000893:Anti-Inflammatory Agents; D010406:Penicillins; D011241:Prednisone