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E. Schoeler, S. Winterhalter, K. Schmitz, A. Joussen; Terson Syndrome - Retrospective Analysis of Visual Outcome After Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5215.
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This study aimed to investigate the visual outcome in patients with terson syndrome with regard to the time of pars plana vitrectomy after the acute event.
Ten eyes of six patients with terson syndrome are reported. In 4 patients both eyes and in 2 patients one eye were concerned. Due to missing tendency of spontaneous resorption of the vitreous haemorrhage in 9 eyes, pars plana vitrectomy was conducted within 2 ½ and 5 months (average 3 months). In one eye the haemorrhage resolved spontaneously within 4 weeks after the event.
In all cases, there was no posterior vitreous detachment present at time of surgery. In several patients intraretinal haemorrhage was combined with subhyaloidal haemorrhage. In 7 eyes visual acuity improved after pars plana vitrectomy. Severe complications occurred in one eye. In this case a second operation was necessary due to PVR detachment one month after the first vitrectomy. Mean visual acuity before operation ranged from light perception to 20/200. Postoperatively visual acuity increased to handmovement up to 20/20.
Early pars plana vitrectomy is recommended in eyes with vitreous haemorrhage due to terson syndrome. The etiology of haemorrhage however results in variable outcomes possibly due to optic nerve damage and retinal neuronal damage. Furthermore, vitreous haemorrhage in patients with terson syndrome has a reduced tendency to resorb. Especially bilateral cases require early visual rehabilitation. Thus, we recommend to perform vitrectomy within 3 months.
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