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F. Ferreri, P. Aragona, F. Lorino, A. Roszkowska, F. Palamara, G. Ferreri; Terson’s Syndrome: An Optical Coherence Tomography (OCT) - Case Report. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3231.
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To evaluate by optical coherence tomography (OCT) the involvement in full macular thickness, in the optic disk and in RNFL (retinal nerve fiber layer) in Terson’s syndrome (TS) due to the occurrence of subarachnoidal haemorrhage (SAH) accompanied by intra-vitreal bleeding.
A 55 year-old woman presenting headache, vomiting and loss of consciousness of sudden onset is reported. Upon testing right eye presented amaurosis while left eye showed a visual acuity of 20/50 . Fluorescein angiography and fundus photographs were performed; the OCT evaluation for macula, optic disk and RNFL involvement was carried out.
OCT documented in the left eyes the presence of an elevated macula due to preretinal hemorrhages occurring at the interface between the posterior hyaloid and the inner limiting membrane (ILM) which showed light fibrotic folding, with an incomplete formation of epiretinal membrane.The optic disk showed papilledema; the RNFL study demonstrated an increased thickness, due to the presence of haemorrhage between the ILM and the RNFL itself.
A previously unreported OCT findings of vitreo-retinal haemorrhages following sudden endocranic pressure increase was shown. Such haemorrhage usually occur at the interface between the posterior hyaloid and ILM, and determine the incomplete formation of an epiretinal membrane overlying the haemorrhage.The OCT provided the evidence for macular thickening associated with optic disk and RNFL which lead to a severe visual impairment. The importance to study TS patients with OCT is underlined, both in order to provide the adequate nursing care and to be able to perform early vitrectomy to restore visual function.
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