학술논문

Terson Syndrome--Clinical Presentation, Management, and Visual Outcomes in a Tertiary Centre
Document Type
Academic Journal
Source
Clinical Ophthalmology. January 31, 2023, Vol. 16, p351, 9 p.
Subject
Portugal
Language
English
ISSN
1177-5483
Abstract
Purpose: The purpose of this study was to characterize the clinical presentation, management strategy and visual outcomes of patients diagnosed with Terson syndrome and followed in a tertiary centre in Portugal. Patients and Methods: A single-centre retrospective study was performed, based on the survey review of the medical records of every consecutive patient diagnosed with Terson syndrome and followed from January 2018 to August 2021. The change in best-corrected visual acuity (BCVA) from baseline to the final evaluation was the primary outcome. Results: Fifteen eyes from 8 patients (50% female) were included. The mean age at diagnosis was 55 [+ or -] 7 years. The neurological event was traumatic brain injury in 37.5% (n=3) and subarachnoid haemorrhage in 62.5% of the patients (n=5). Bilateral intraocular haemorrhage occurred in 875% (n=7) of the patients. Vitreous and preretinal haemorrhages occurred each in 66.7% (n=10), intraretinal in 30% (n=3) and subretinal in 13.3% (n=2) of the eyes. In 40% of the eyes (n=6), spontaneous resolution of intraocular haemorrhage occurred, while PPV was performed in the remaining 60% (n=9). Ocular haemorrhage detection occurred 58.47 [+ or -] 40.94 days after the neurological event (range 11 to 121 days). Baseline BCVA was 1.11 [+ or -] 1.01 logMAR and improved to 0.32 [+ or -] 0.69 logMAR in the follow-up period (p=0.004). A positive correlation was found between initial and final BCVA (Spearman's rho = 0.643, p=0.01). Baseline BCVA of eyes undergoing PPV was lower than of those conservatively managed (1.84[+ or -]0.72 vs 0.20[+ or - ]0.28 logMAR, p Conclusion: Terson syndrome is a potential cause of irreversible visual loss. Diagnosis delay may affect visual prognosis. PPV is indicated when intraocular haemorrhage is dense and does not resolve spontaneously or when visual acuity at presentation is low, allowing for good visual outcomes with minimal complications. Keywords: Terson syndrome, management, vitrectomy, visual outcomes, clinical presentation
Introduction Terson syndrome was first described by Moritz Litten in 1881 and later named by Albert Terson in 1900, as an association between subarachnoid haemorrhage and vitreous hemorrhage. (1,2) This [...]