Clinical features and visual prognostic indicators after vitrectomy for Terson syndrome

Area of Science:

• Ophthalmology
• Neurosurgery
• Vitreoretinal Surgery

Background:

• Terson syndrome (TS) involves vitreous hemorrhage (VH) often linked to serious neurological events.
• Predicting visual outcomes in TS patients after vitrectomy is crucial for patient management.

Purpose of the Study:

• To identify clinical characteristics and prognostic factors for visual recovery in Terson syndrome patients post-vitrectomy.
• To analyze the impact of underlying causes and surgical timing on visual outcomes.

Main Methods:

• Retrospective review of 48 patients (54 eyes) who underwent vitrectomy for Terson syndrome-related VH.
• Analysis of final postoperative best-corrected visual acuity (BCVA) as the primary outcome measure.

Main Results:

• 63% of eyes achieved a BCVA of 0.3 or better.
• Eyes with traumatic brain injury (TBI) showed better visual outcomes than those with primary intracerebral hemorrhage (ICH).
• Hypertension-induced ICH was associated with poorer outcomes compared to ruptured intracranial aneurysms; delayed vitrectomy correlated with more epiretinal membrane and peripheral retinal changes, though final visual acuity was not significantly different.

Conclusions:

• Vitrectomy is effective for visual recovery in Terson syndrome.
• Ruptured intracranial aneurysms, TBI, and absence of retinal hemorrhage predict better prognosis.
• While not statistically significant, early vitrectomy (within 3 months) may reduce complications like epiretinal membrane formation and retinal tears.