Unilateral Terson syndrome. Outcome after early vitrectomy

Abstract

Purpose To report the clinical features and the results after an early vitrectomy of a case of a Terson syndrome following an aneurysmal subarachnoid hemorrhage Methods 32 years old male with decreased visual acuity (VA) of the right eye (RE) of evolution difficult to determine. As recent precedent a month before stands out a subarachnoid and parenchymal hemorrhage secondary to ruptured aneurysm of the right medial cerebral artery, treated by external ventricular drainage and posterior surgical clipping with satisfactory outcome. The examination revealed visual acuity of light perception in RE and funduscopy shows widespread vitreous haze with impossibility of glimpse the retina, with fibrinous‐looking condensations Results Suspecting Terson syndrome a pars plana vitrectomy is performed with aspiration of subhyaloid bleeding in the posterior pole. The patient achieved a VA of 0.9 and the funduscopy shows the demarcation zone of ancient bleeding in the posterior pole Conclusion Terson's syndrome is the combination of intraocular bleeding and subarachnoid hemorrhage secondary to rupture of an aneurysm. The bleeding can be intraretinal, subretinal or vitreal. It is a commonly underdiagnosed pathology. It is associated with worse neurological prognosis with higher rates of morbidity and mortality. However, vitreous hemorrhage is usually resolved spontaneously within a few months, and generally has good long‐term visual prognosis. But early vitrectomy is indicated in bilateral cases, persistent bleeding or proliferative vitreoretinopathy