P Meier1, P Wiedemann. 1. Klinik und Poliklinik für Augenheilkunde Universität Leipzig.
Abstract
BACKGROUND: Terson syndrome is defined as the presence of intraocular hemorrhages in association with a sudden increase in intracranial pressure. The hemorrhages can occur in the subretinal space, within the sensory retina, between the retina and the hyaloid membrane and in the vitreous cavity. PATIENTS: We report about three eyes from two patients with Terson syndrome, in which vitreous hemorrhages were noted. In one eye we observed a preretinal macular hemorrhage. Pars plana vitrectomy was performed in two eyes. RESULTS: The hyaloid was surgically peeled away, which showed a membrane covering the macula. When this membrane was stripped away a retinal fold 360 degrees surrounding the macula was noted, in one eye a light fibrotic line was visible. The premacular hemorrhage and the intrahyaloidal hemorrhages in this eye were resorbed spontaneously after 5 months. In all eyes visual acuity increased to 1,0. CONCLUSION: In most eyes with Terson syndrome it is possible to wait for the spontaneous resorption of the blood. It is hypothesized that blood from a ruptured vein or capillary hydrodissects the internal limiting membrane from the underlying neurosensory retina. If a pars plana vitrectomy is performed the possibility of a hydraulical dissected internal limiting membrane has to be considered. Postoperatively perimacular retinal folds or fibrotic lines may occur, they didn't have any clinical evidence.
BACKGROUND:Terson syndrome is defined as the presence of intraocular hemorrhages in association with a sudden increase in intracranial pressure. The hemorrhages can occur in the subretinal space, within the sensory retina, between the retina and the hyaloid membrane and in the vitreous cavity. PATIENTS: We report about three eyes from two patients with Terson syndrome, in which vitreous hemorrhages were noted. In one eye we observed a preretinal macular hemorrhage. Pars plana vitrectomy was performed in two eyes. RESULTS: The hyaloid was surgically peeled away, which showed a membrane covering the macula. When this membrane was stripped away a retinal fold 360 degrees surrounding the macula was noted, in one eye a light fibrotic line was visible. The premacular hemorrhage and the intrahyaloidal hemorrhages in this eye were resorbed spontaneously after 5 months. In all eyes visual acuity increased to 1,0. CONCLUSION: In most eyes with Terson syndrome it is possible to wait for the spontaneous resorption of the blood. It is hypothesized that blood from a ruptured vein or capillary hydrodissects the internal limiting membrane from the underlying neurosensory retina. If a pars plana vitrectomy is performed the possibility of a hydraulical dissected internal limiting membrane has to be considered. Postoperatively perimacular retinal folds or fibrotic lines may occur, they didn't have any clinical evidence.