June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
A prospective study on Terson’s syndrome and intraocular infections in critically ill patients
Author Affiliations & Notes
  • Daniel Barthelmes
    Ophthalmology and Eye health, The University of Sydney, Sydney, NSW, Australia
    Intensive Care Medicine, University Hospital Bern, Bern, Switzerland
  • Matthias Haenggi
    Intensive Care Medicine, University Hospital Bern, Bern, Switzerland
  • Tobias Merz
    Intensive Care Medicine, University Hospital Bern, Bern, Switzerland
  • Jukka Takala
    Intensive Care Medicine, University Hospital Bern, Bern, Switzerland
  • Michael Lensch
    Intensive Care Medicine, University Hospital Bern, Bern, Switzerland
  • Stephan Jakob
    Intensive Care Medicine, University Hospital Bern, Bern, Switzerland
  • Footnotes
    Commercial Relationships Daniel Barthelmes, None; Matthias Haenggi, None; Tobias Merz, None; Jukka Takala, None; Michael Lensch, None; Stephan Jakob, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5756. doi:
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      Daniel Barthelmes, Matthias Haenggi, Tobias Merz, Jukka Takala, Michael Lensch, Stephan Jakob; A prospective study on Terson’s syndrome and intraocular infections in critically ill patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5756.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To assess the incidence of intraocular sequelae (hemorrhages, bacterial and fungal infections) in a high-risk population of patients in an intensive care unit (ICU).

Methods: Prospective, non-interventional study over a period of 10 months. Inclusion criteria: severe head injury (Glascow Coma Scale [GCS] score < 9), intracranial hemorrhages (subarachnoidal, subdural, epidural), thrombocyte count <100,000/ml, severe sepsis. Exclusion criteria: ICU stay ≤ 3 days, direct trauma to eye or orbit. Daily fundoscopy, recording of routine clinical parameters, including coagulation parameters, drained cerebrospinal fluid, blood pressure, intracranial pressure, blood glucose, and leukocyte count.

Results: Seventy-eight patients were included; six (7.7%) of them had intraocular hemorrhages (IOH). None had intraocular bacterial or fungal infections. One of 10 (10%) patients with subarachnoidal hemorrhage, 3 of 20 (15%) patients with sepsis and septic shock and 2 of 16 (13%) patients with craniocerebral trauma had IOH. Overall mortality was 14%. Four patients (67%) with IOH but only 8% of patients without IOH died (p=0.0019). In the sepsis and septic shock group only patients with IOH died; there the IOH occurred shortly before death in each case. No predictive factor for IOH could be determined based on the parameters evaluated.

Conclusions: Intraocular infections or hemorrhages occur only in a minority of a high-risk population of ICU patients. Based on current data, general screening for such events cannot be advocated.

Keywords: 742 trauma • 557 inflammation • 688 retina  
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