Outcome indicators for vitrectomy in Terson syndrome.
OBJECTIVE
There is no general agreement on the best indication and timing of vitrectomy in patients suffering from Terson syndrome. Therefore, we reviewed our cases in order to assess factors interfering with the functional outcome and complication rates after vitrectomy.


METHODS
In this retrospective consecutive case series, the records from all patients undergoing vitrectomy for Terson syndrome between 1975 and 2005 were evaluated.


RESULTS
Thirty-seven patients (45 eyes) were identified, 36 of whom (44 corresponding eyes) were eligible. The best-corrected visual acuity (BCVA) at first and last presentation was 0.07 +/- 0.12 and 0.72 +/- 0.31, respectively. Thirty-five eyes (79.5%) achieved a postoperative BCVA of > or = 0.5; 26 (59.1%) eyes achieved a postoperative BCVA of > or = 0.8. Patients operated on within 90 days of vitreous haemorrhage achieved a better final BCVA than those with a longer latency (BCVA of 0.87 +/- 0.27 compared to 0.66 +/- 0.31; P = 0.03). Patients younger than 45 years of age achieved a better final BCVA than older patients (0.85 +/- 0.24 compared to 0.60 +/- 0.33; P = 0.006). Retinal detachment developed in four patients between 6 and 27 months after surgery. Seven patients (16%) required epiretinal membrane peeling and seven cataract surgery.


CONCLUSIONS
Ninety-eight per cent of our patients experienced a rapid and persisting visual recovery after removal of a vitreous haemorrhage caused by Terson syndrome. A shorter time between occurrence of vitreous haemorrhage and surgery as well as a younger patient age are predictive of a better outcome. Generally, the surgical risk is low, but complications (namely retinal detachment) may occur late after surgery.
Swiss Eye Institute, Bern, Switzerland. justus.garweg@swiss-eye-institute.com
Justus G
JG
Garweg
Fritz
F
Koerner
D000328:Adult; D000367:Age Factors; D000368:Aged; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020127:Recovery of Function; D012086:Reoperation; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013577:Syndrome; D013997:Time Factors; D014792:Visual Acuity; D014821:Vitrectomy / Q000009:adverse effects; D018630:Vitreoretinopathy, Proliferative / Q000150:complications; D014823:Vitreous Hemorrhage / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*