Takeshi Iwase1, Nobushige Tanaka. 1. Department of Ophthalmology, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama City, Toyama, Japan. TsuyoshiIwase@aol.com
Abstract
PURPOSE: To present a case of Terson's syndrome with bilateral subretinal haemorrhage emanated from peripapilla, resulting in Mariotte blind spot enlargement. METHODS: Preoperative CT scan and postoperative eye examinations, including funduscopy, fluorescein angiography, optical coherence tomography (OCT), and Goldmann perimetry. RESULTS: A 41-year-old Japanese man had suffered a subarachnoid haemorrhage. Three months later, he recovered from disturbance of consciousness and was referred for decreased vision in both eyes. A CT scan, obtained on the day after the event, had revealed bilateral vitreous hemorrhage. The patient underwent a standard pars plana vitrectomy to clear vitreous haemorrhage. Surprisingly we found bilateral subretinal haemorrhage around peripapilla during surgery. Although subretinal haemorrhage was almost absorbed at six months after the operation, Mariotte blind spot enlargement corresponding to the area of subretinal haemorrhage was detected in both eyes. CONCLUSIONS: In some population of the patients with Terson's syndrome, it was demonstrated that the disturbance of peripapillary structure, presumably due to intracranial hypertension, causes subretinal haemorrhage, resulting in irreversible visual field defect.
PURPOSE: To present a case of Terson's syndrome with bilateral subretinal haemorrhage emanated from peripapilla, resulting in Mariotte blind spot enlargement. METHODS: Preoperative CT scan and postoperative eye examinations, including funduscopy, fluorescein angiography, optical coherence tomography (OCT), and Goldmann perimetry. RESULTS: A 41-year-old Japanese man had suffered a subarachnoid haemorrhage. Three months later, he recovered from disturbance of consciousness and was referred for decreased vision in both eyes. A CT scan, obtained on the day after the event, had revealed bilateral vitreous hemorrhage. The patient underwent a standard pars plana vitrectomy to clear vitreous haemorrhage. Surprisingly we found bilateral subretinal haemorrhage around peripapilla during surgery. Although subretinal haemorrhage was almost absorbed at six months after the operation, Mariotte blind spot enlargement corresponding to the area of subretinal haemorrhage was detected in both eyes. CONCLUSIONS: In some population of the patients with Terson's syndrome, it was demonstrated that the disturbance of peripapillary structure, presumably due to intracranial hypertension, causes subretinal haemorrhage, resulting in irreversible visual field defect.