[Terson syndrome--a contribution to the timing of operation for pars plana vitrectomy]

This study aimed to investigate the possible differences in final outcome in patients with Terson syndrome (1996 - 2005) with regard to the time of vitrectomy after the acute event.

Eighteen eyes from eleven patients with Terson syndrome are reported. All eyes showed considerable haemorrhages without any tendency of resorption. Eleven eyes were operated within 3 months after the acute injury. In seven eyes pars plana vitrectomy was performed 4 - 6 months after the acute event because of the patient's poor general state of health. In three patients only one eye was impaired.

Seven eyes with Terson syndrome which were operated 4 - 6 months after injury showed severe complications intra- and postoperatively (ring-shaped proliferations with traction at the posterior pole, optic disc atrophy and maculopathy). On average, 2.4 operations were necessary. Within a mean postoperative observation period of 3.9 years (8 months to 8.5 years), the visual acuity was between light perception and 0.7 (mean: 0.25). In eleven eyes, however, pars plana vitrectomy was performed already 1 - 3 months after the acute event. In these cases few complications occurred intra- and postoperatively. On average, only 1.1 operations were necessary. After the clinical attendance (observation period: one weak to four years, mean: 2.1 years) the visual acuity amounted to between light perception and 0.8 (mean: 0.6). In one eye a sudden spontaneous blood resorption took place.

Because of severe complications and in view of an early rehabilitation of the patients, vitrectomy has been recommended for eyes with bilateral Terson syndrome and with poor or absent tendency of blood resorption. Vitrectomy should be performed at least in one eye within three months after the acute event.