Terson Syndrome With Bilateral Optic Nerve Sheath Hemorrhage

Gauntt, Chiaki D.; Sherry, Richard G; Kannan, Chithra

doi:10.1097/wno.0b013e31814b22dc

Cited by 13 publications

(3 citation statements)

References 12 publications

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“…Our results have shown that OUS as a bedside, non-invasive tool is of high diagnostic value and provides high accuracy detecting ocular pathologies, confirming previous findings by Blaivas et al and others [14] , [15] , [17] , [18] . This is of special interest to neuro-intensive care and neurological rehabilitation units, as OUS is not routinely performed in SAH patients, where IOH followed by temporary or permanent visual acuity may affect nearly half of all patients [6] .…”

Section: Discussionsupporting

confidence: 92%

Ocular Ultrasound as an Easy Applicable Tool for Detection of Terson's Syndrome after Aneurysmal Subarachnoid Hemorrhage

et al. 2014

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IntroductionIntraocular hemorrhage in patients suffering from aneurysmal subarachnoid hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome.Material and MethodsFifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an intraocular hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an intraocular hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound.ResultsIndirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of intraocular hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome.ConclusionsOcular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome.

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Section: Discussionsupporting

confidence: 92%

Ocular Ultrasound as an Easy Applicable Tool for Detection of Terson's Syndrome after Aneurysmal Subarachnoid Hemorrhage

et al. 2014

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“…6,16 The heavily T2-weighed MR image in the present case revealed that the subarachnoid hemorrhage had entered the intervaginal subarachnoid space of the optic nerve of both eyes. Noting that the dilatation of the subarachnoid space around the optic nerve was more prominent in the left eye, we determined that more blood had entered the subarachnoid space in the left eye.…”

Section: Discussionmentioning

confidence: 96%

Magnetic resonance imaging findings of Terson’s syndrome suggesting a possible vitreous hemorrhage mechanism

Sakamoto¹,

Nakamura

Shibata

et al. 2010

Jpn J Ophthalmol

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“…Increased intracranial venous pressure generated in the retinal veins causes stasis and rupturing of superficial retinal vessels, leading to the intraocular haemorrhage. This theory explains the occurrence of Terson syndrome in cases other than subarachnoid haemorrhage [2,5,8].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of vitrectomy in Terson syndrome — case series

Koman

Gajda²,

Kiszka³

et al. 2016

Ophthalmology J

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The visual outcomes of vitrectomy in a series of five eyes of three patients with vitreous haemorrhage due to Terson syndrome were retrospectively evaluated. There were two bilateral cases and one unilateral. The neurological diagnosis included cranio-cerebral trauma and cerebral aneurysm rupture. The mean time interval between intracranial haemorrhage and vitrectomy was nine months (range 7-10 months). Pars plana vitrectomy was performed with BSS as a tamponade in three eyes, SF6 gas in one eye, and silicone oil in one eye. The mean follow-up period was 12 months (range 1-27 months). Visual acuity improved significantly in all patients from counting fingers to the mean value of 0.6 (range 0.1-1.0). We observed one epiretinal membrane, one tractional retinal detachment, and two cataract formations. The best visual outcomes were achieved with BSS as a tamponade, the worst was with silicone oil as a tamponade and retinal detachment. Performing vitrectomy with BSS as a tamponade in patients with Terson syndrome significantly improves visual acuity, so early diagnosis and surgical treatment are crucial.

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Terson Syndrome With Bilateral Optic Nerve Sheath Hemorrhage

Cited by 13 publications

References 12 publications

Ocular Ultrasound as an Easy Applicable Tool for Detection of Terson's Syndrome after Aneurysmal Subarachnoid Hemorrhage

Ocular Ultrasound as an Easy Applicable Tool for Detection of Terson's Syndrome after Aneurysmal Subarachnoid Hemorrhage

Magnetic resonance imaging findings of Terson’s syndrome suggesting a possible vitreous hemorrhage mechanism

Effectiveness of vitrectomy in Terson syndrome — case series

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