Studying the features of the developement, clinical course and surgical treatment of hemophthalmos in terson's syndrome

Abstract

Local or total hemophthalmos, which develops due to venous hypertension and subsequent advancement of intracranial pressure after hemorrhage in the cerebrum in Terson syndrome (TS). The purpose of our research was to study the features of development, clinical course and surgical treatment of hemophthalmos in Terson's syndrome. 40 patients (80 eyes), 18 women and 22 men, aged 18 to 75 years, with intracranial hemorrhage (ICH) were examined. All patients gave informed voluntary consent to participate in the study. All patients were initially treated with observation and conservative treatment. If the treatment was ineffective for 4-5 weeks, we performed surgical intervention. We performed pars plana vitrectomy (PPV) 23/27ga with removal of the ILM and endotamponade with a gas-air mixture. The frequency of Terson's syndrome was analyzed taking into account gender, age, cause of ICH, presence of coma in the anamnesis, and the fact of neurosurgery. The localization and type of hemorrhage in Terson's syndrome and visual results, the frequency of complications and recurrences during the entire period of observation were also determined. ST was diagnosed in 25% of cases. The frequency of development of ST was statistically significantly higher in women than in men, in patients aged 30 to 60 years, as well as among cases of non-traumatic IHD. It was found that coma and the presence of neurosurgical intervention in the anamnesis are also factors associated with a statistically significantly higher frequency of ST. In CT, cases of subhyaloid and subILM hemorrhage were more often observed in CT. Surgical treatment (PPV) was required in 60% of cases. A statistically significant improvement of visual functions was established after the operation. A single case of recurrence of hemophthalmos was recorded, which was associated with late postoperative complications. The results of our study complement the data published in the literature on the peculiarities of the occurrence, clinical course and treatment of Terson's syndrome, and confirm that surgical intervention for hemophthalmos in this case is necessary in more than half of the cases, and statistically significantly improves the visual functions of patients. The risk of surgery, taking into account the frequency of complications and recurrences, was low in our study.