Skip to main content

Advertisement

Log in

Anatomical and functional outcomes following vitrectomy for dense vitreous hemorrhage related to Terson syndrome in children

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

Our purpose was to assess anatomical and functional outcomes of vitrectomy in pediatric cases of Terson syndrome.

Methods

A total of 11 eyes of seven children diagnosed with Terson syndrome secondary to traumatic brain injury and 17 eyes of 12 children diagnosed with Terson syndrome secondary to nontraumatic brain hemorrhage who had 20-gauge or 23-gauge pars plana or pars plicata vitrectomy were included in this retrospective study. The primary outcome was the change in visual acuity from the preoperative examination to postoperative final follow-up. Secondary outcomes were anatomic surgical success and postoperative complications.

Results

The mean time between diagnosis and surgery was 62 ± 35 days (range, 30–150), and the average age at the time of the surgery was 4.5 ± 6.4 years (range, 3 months to 17 years). The mean preoperative logarithm of the minimum angle of resolution (logMAR) (Snellen) best corrected visual acuity (BCVA) was 2.6 ± 0.7 (20/7260) (n = 9) and in the remaining 19 eyes it was recorded as noncentral, unsteady, nonmaintained fixation. The mean follow-up period was 50 ± 54 months (range, 12–192 months). At the last follow-up visit, the mean logMAR BCVA was 0.46 ± 0.6 (20/60) (n = 19) and in eight eyes it was recorded as fix-and-follow. One eye developed a retinal detachment 14 months after the first operation, and one eye developed an epiretinal membrane after 2 years. Anatomical success was recorded in all patients at the final visit.

Conclusions

In children with massive vitreous hemorrhage secondary to Terson syndrome, vitrectomy is an effective procedure and offers a rapid visual improvement. Earlier surgical treatment prevents amblyopia and blood-related potential complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Spirn MJ, Lynn MJ, Hubbard GB (2006) Vitreous hemorrhage in children. Ophthalmology 113(5):848–852

    Article  PubMed  Google Scholar 

  2. Rishi P, Rishi E, Gupta A, Swaminathan M, Chhablani J (2013) Vitreous hemorrhage in children and adolescents in India. J AAPOS 17(1):64–69

    Article  PubMed  Google Scholar 

  3. Sudhalkar A, Chhablani J, Jalali S, Mathai A, Pathengay A (2013) Spontaneous vitreous hemorrhage in children. Am J Ophthalmol 156(6):1267–1271

    Article  PubMed  Google Scholar 

  4. Terson A (1900) De l’hemorrhagie dans le corps vitre au cours de l’hemorrhagie cerebrale. Clin Ophthalmol 6:309–312

    Google Scholar 

  5. Weingeist TA, Goldman EJ, Folk JC, Packer AJ, Ossoinig KC (1986) Terson’s syndrome. Clinicopathologic correlations. Ophthalmology 93(11):1435–1442

    Article  CAS  PubMed  Google Scholar 

  6. Ko F, Knox DL (2010) The ocular pathology of Terson’s syndrome. Ophthalmology 117(7):1423–1429.e2

    Article  PubMed  Google Scholar 

  7. Czorlich P, Skevas C, Knospe V et al (2015) Terson syndrome in subarachnoid hemorrhage, intracerebral hemorrhage and traumatic brain injury. Neurosurg Rev 38(1):129–136

    Article  PubMed  Google Scholar 

  8. Manschot WA (1954) Subarachnoid hemorrhage. Intraocular symptoms and their pathogenesis. Am J Ophthalmol 38(4):501–505

    Article  CAS  PubMed  Google Scholar 

  9. Schloff S, Mullaney PB, Armstrong DC et al (2002) Retinal findings in children with intracranial hemorrhage. Ophthalmology 109(8):1472–1476

    Article  PubMed  Google Scholar 

  10. Capone A (2003) Lens-sparing vitreous surgery for infantile amblyogenic vitreous hemorrhage. Retina 23(6):792–795

    Article  PubMed  Google Scholar 

  11. Gnanaraj L, Tyagi AK, Cottrell DG et al (2000) Referral delay and ocular surgical outcome in Terson syndrome. Retina 20(4):374–377

    Article  CAS  PubMed  Google Scholar 

  12. Garweg JG, Koerner F (2009) Outcome indicators for vitrectomy in Terson syndrome. Acta Ophthalmol 87(2):222–226

    Article  PubMed  Google Scholar 

  13. Narayanan R, Taylar SC, Nayaka A et al (2017) Visual outcomes after vitrectomy for Terson syndrome secondary to traumatic brain injury. Ophthalmology 124(1):118–122

    Article  PubMed  Google Scholar 

  14. Al-Jarallah A, Al-Rifai MT, Riela AR, Roach ES (2000) Nontraumatic brain hemorrhage in children: etiology and presentation. J Child Neurol 15(5):284–289

    Article  CAS  PubMed  Google Scholar 

  15. Maguire SA, Watts PO, Shaw AD et al (2013) Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review. Eye (Lond) 27(1):28–36

    Article  CAS  Google Scholar 

  16. Kuhn F, Morris R, Witherspoon D, Mester V (1998) Terson syndrome. Results of vitrectomy and the significance of vitreous hemorrhage in patients with subarachnoid hemorrhage. Ophthalmology 105(3):472–477

    Article  CAS  PubMed  Google Scholar 

  17. Srinavasan S, Kyle G (2006) Subinternal limiting membrane and subhyaloid haemorrhage in Terson syndrome: the macular ‘double ring’ sign. Eye 20:1099–1101

    Article  Google Scholar 

  18. Schultz PN, Sobol WM, Weingeist TA (1991) Long-term visual outcome in Terson syndrome. Ophthalmology 98(12):1814–1819

    Article  CAS  PubMed  Google Scholar 

  19. Velikay M, Datlinger P, Stolba U, Wedrich A, Binder S, Hausmann N (1994) Retinal detachment with severe proliferative vitreoretinopathy in Terson syndrome. Ophthalmology 101(1):35–37

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Murat Karacorlu.

Ethics declarations

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. “For this type of study formal consent is not required.”

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sayman Muslubas, I., Karacorlu, M., Hocaoglu, M. et al. Anatomical and functional outcomes following vitrectomy for dense vitreous hemorrhage related to Terson syndrome in children. Graefes Arch Clin Exp Ophthalmol 256, 503–510 (2018). https://doi.org/10.1007/s00417-017-3887-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-017-3887-3

Keywords

Navigation