Frequency of ocular hemorrhages in patients with subarachnoidal hemorrhage.
BACKGROUND
Vitreous hemorrhage (Terson's syndrome) and other intraocular hemorrhages have been reported in up to 40% of patients with subarachnoidal hemorrhage (SAH). Our objective was to determine prospectively the frequency of intraocular involvement and its relationship to the grade of SAH.


METHODS
Seventy-four consecutive patients with SAH were prospectively examined. The patients were classified according to Hunt and Hess and ophthalmological examination was performed by an ophthalmologist.


RESULTS
In all patients SAH was caused by a ruptured cerebral aneurysm. Intraocular hemorrhages were present in 28% of the patients, all of whom had retinal hemorrhages, which were detectable unilaterally in 45%, while 15% of these patients exhibited typical retrohyaloidal or vitreal hemorrhages. Ocular involvement was statistically more frequent in patients with a higher grade of SAH according to Hunt and Hess.


CONCLUSIONS
Due to ocular involvement in more than a quarter of the patients with SAH and due to the fact that ocular involvement is related to the severity of SAH, screening of patients with SAH is recommended, especially when no reliable data about visual function are available. Early vitrectomy of vitreous hemorrhages provides a more effective rehabilitation.
Ness
T
T
University Eye Hospital Freiburg, Killianstrasse 5, 79106 Freiburg, Germany. ness@aug.ukl.uni-freiburg.de
Janknecht
P
P
Berghorn
C
C
D017542:Aneurysm, Ruptured / Q000150:complications; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000453:epidemiology*; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D014823:Vitreous Hemorrhage / Q000453:epidemiology*