Sub-inner limiting membrane hemorrhage in a patient with Terson syndrome

To report a case of bilateral Terson Syndrome with sub inner limiting membrane hemorrhage associated with a rare finding: perimacular fold.

The patient, a 34 years old female with aneurysmal subarachnoid hemorrhage and bilateral Terson syndrome was admitted to the Ophthalmology department, complaining of blurred vision. Core vitrectomy, hyaloid detachment, peeling of the ILM and aspiration of the sub inner limiting membrane hemorrhage was performed. Once the inner limiting membrane of the left eye was peeled off, we noticed a particular aspect: the perimacular fold.

Although our patient suffered from a massive vitreous haemorrhage the postoperative outcome was favorable with a final best corrected visual acuity of 20/30.

In patients with billateral Terson syndrome we recommend early surgery, especially if the neurological status allows it, a good visual acuity being helpful for the neurophysical rehabilitation of the patient.