Anatomical and functional outcomes following vitrectomy for dense vitreous hemorrhage related to Terson syndrome in children

• Published in: Graefe's archive for clinical and experimental ophthalmology 2018-03, Vol.256 (3), p.503-510
• Main Authors: Sayman Muslubas, Isil, Karacorlu, Murat, Hocaoglu, Mumin, Ersoz, Mehmet Giray, Arf, Serra
• Format: Article
• Language: English
• Subjects: Acuity; Children; Eye; Hemorrhage; Medicine; Medicine & Public Health; Ophthalmology; Retina; Retinal Disorders; Surgery; Traumatic brain injury
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-017-3887-3

Purpose Our purpose was to assess anatomical and functional outcomes of vitrectomy in pediatric cases of Terson syndrome. Methods A total of 11 eyes of seven children diagnosed with Terson syndrome secondary to traumatic brain injury and 17 eyes of 12 children diagnosed with Terson syndrome secondary to nontraumatic brain hemorrhage who had 20-gauge or 23-gauge pars plana or pars plicata vitrectomy were included in this retrospective study. The primary outcome was the change in visual acuity from the preoperative examination to postoperative final follow-up. Secondary outcomes were anatomic surgical success and postoperative complications. Results The mean time between diagnosis and surgery was 62 ± 35 days (range, 30–150), and the average age at the time of the surgery was 4.5 ± 6.4 years (range, 3 months to 17 years). The mean preoperative logarithm of the minimum angle of resolution (logMAR) (Snellen) best corrected visual acuity (BCVA) was 2.6 ± 0.7 (20/7260) ( n  = 9) and in the remaining 19 eyes it was recorded as noncentral, unsteady, nonmaintained fixation. The mean follow-up period was 50 ± 54 months (range, 12–192 months). At the last follow-up visit, the mean logMAR BCVA was 0.46 ± 0.6 (20/60) ( n  = 19) and in eight eyes it was recorded as fix-and-follow. One eye developed a retinal detachment 14 months after the first operation, and one eye developed an epiretinal membrane after 2 years. Anatomical success was recorded in all patients at the final visit. Conclusions In children with massive vitreous hemorrhage secondary to Terson syndrome, vitrectomy is an effective procedure and offers a rapid visual improvement. Earlier surgical treatment prevents amblyopia and blood-related potential complications.