Vitreous findings in a patient with Terson's syndrome

Abstract

In Terson's syndrome a sudden increase in intracranial pressure due to spontaneous subarachnoid hemorrhage or head trauma may result in intraocular hemorrhage. A patient with bilateral vitreous hemorrhages underwent vitrectomy in both eyes with excellent result. In the right eye a glistening membrane was found with blood underneath, covering the macula. This was probably the internal limiting membrane (ILM). At the vitreous base and in the equatorial zone, attachment plaques are present between the ILM and the Müller cells. Because attachment plaques are missing in the posterior zone, where the ILM is much thicker, a retinal hemorrhage is capable of detaching the ILM from the retina in that area. The presence of attachment plaques is considered in relation to centripetal vitreous traction, which is absent in the area of the posterior precortical vitreous pocket (PPVP). The posterior wall of the PPVP coincides therefore probably exactly with the thick part of the ILM in the posterior zone.

Vitrectomy for premacular hemorrhagic cyst in children and young adults

“…With the exception of patient 6, all maculae showed an encircling retinal fold [8], perimacular demarcation line [11], or a ridge completely surrounding the macula [16] postoperatively. These corresponded to the edge of the HMC, i.e., the edge of the hemorrhagic detachment of ILM.…”

“…b The fibrotic membrane could be removed completely, and after vitrectomy with air/ SF 6 gas tamponade the retina reattached postoperatively HMC to peripheral. This procedure gave rise to two retinal holes, because on the posterior pole the ILM is joined more to the underlying retina than to the peripheral part [16]. This is caused by attachment plaques of the ILM with the footplates of the underlying Müller cells.…”

Surgery for Pediatric Vitreoretinal Disorders

“…The authors estimate the incidence of Terson syndrome in children with intracranial hemorrhage to be less than 8%. 68 Most cases of vitreous and retinal hemorrhages in Terson syndrome do not require surgery because of spontaneous resorption. Three case reports of Terson syndrome in babies, from 5 weeks to 7 months old, due to a ruptured angiodysplasia or an aneurysma have been published.…”

Hemorragia subaracnóidea e síndrome de Terson: estudo prospectivo

“…Mais tarde, foram descritos casos de hemorragia vítrea após hemorragia subaracnóidea e subdural seguida de traumatismos crânio-encefálicos (1)(2) . A observação de hemorragia intra-ocular tem grande importância no prognóstico de vida e alta taxa de mortalidade tem sido relacionada, principalmente em casos bilaterais (3) .…”