Lorenzi Umberto, Buschini Elisa, Fea Antonio, Machetta Federica, Grignolo Federico Maria
Ophthalmic Section, Department of Clinical Pathophysiology, University of Turin, Turin, Italy.
Clin Ophthalmol. 2014 Apr 3;8:681-3. doi: 10.2147/OPTH.S52548. eCollection 2014.
Terson syndrome is defined as intraocular hemorrhage associated with intracranial bleeding. This syndrome can occur in the event of intracranial hemorrhage or elevated intracranial pressure. To our knowledge, it has never been associated with chronic myeloid leukemia. A 45-year-old woman suffering from chronic myeloid leukemia was referred to our clinic with Terson syndrome after intracranial bleeding. We followed this patient for a year, performing visual acuity assessment, fundus examination, color retinography, and A-scan and B-scan ultrasonography. At presentation, her best-corrected visual acuity on the right was 20/63 and on the left was 20/320. In the right eye, retinoscopy showed blurring of the optic margins surrounded by retinal and preretinal hemorrhages, preretinal fibrosis of the optic disc along the vascular arcades, and perivascular retinal infiltrates. In the left eye, the optic disc was surrounded by retinal and preretinal hemorrhages, and massive fibrosis with hard exudates and severe preretinal hemorrhage were observed at the posterior pole. Roth spots and many circular hemorrhages were noted at the periphery of the retina. A-scan and B-scan ultrasonography did not show intraocular leukemic infiltration. The clinical picture remained stable over the following 12 months. In this patient, we observed the ophthalmoscopic features of chronic myeloid leukemia, but also coexistence of features typical of Terson syndrome. To our knowledge, no similar cases have been reported previously.
泰尔森综合征被定义为与颅内出血相关的眼内出血。该综合征可发生于颅内出血或颅内压升高时。据我们所知,它从未与慢性髓系白血病相关联。一名45岁的慢性髓系白血病女性患者在颅内出血后因泰尔森综合征被转诊至我们的诊所。我们对该患者进行了为期一年的随访,进行了视力评估、眼底检查、彩色视网膜造影以及A超和B超检查。初诊时,她右眼的最佳矫正视力为20/63,左眼为20/320。右眼检眼镜检查显示视盘边缘模糊,周围有视网膜和视网膜前出血,视盘沿血管弓处有视网膜前纤维化,以及血管周围视网膜浸润。左眼视盘周围有视网膜和视网膜前出血,在后极部观察到大量纤维化伴硬性渗出物和严重的视网膜前出血。在视网膜周边部可见 Roth斑和许多圆形出血。A超和B超检查未显示眼内白血病浸润。在接下来的12个月里,临床表现保持稳定。在该患者中,我们观察到了慢性髓系白血病的眼底特征,同时也存在泰尔森综合征的典型特征。据我们所知,此前尚未报道过类似病例。