[Vitreous and fundus changes in Terson syndrome. 3 case reports].

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.