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Case Reports
Journal Article
The ocular pathology of Terson's syndrome.
Ophthalmology 2010 July
PURPOSE: To improve understanding of vision loss and clinical findings, we studied gross and microscopic pathology of retinas and optic nerves of individuals with Terson's syndrome.
DESIGN: Retrospective case series with clinicopathologic correlation.
PARTICIPANTS: We included 109 deceased individuals with Terson's syndrome.
METHODS: Histologic sections and gross photographs from 109 cases of Terson's Syndrome, accessed from 1955 to 1992 at the Wm R. Green Laboratory of Ocular Pathology, were studied and photographed; a representative case is described in detail.
MAIN OUTCOME MEASURES: Abnormalities in retina and optic nerve.
RESULTS: Hemorrhages occur in vitreous, subhyaloid, sub-internal limiting membrane (ILM), intraretinal, and subretinal spaces, in association with macular holes, retinal detachments, and optic neuropathy. Subhyaloid hemorrhages have diffuse morphology, whereas sub-ILM are well-demarcated. Continuous and noncontinuous blood occurs along optic nerves, within nerve sheaths, and in the subdural and subarachnoid spaces.
CONCLUSIONS: Blood occurring in various layers and locations of the retina, particularly the macula, causes various complications that influence clinical management and visual outcome. Morphology differentiates subhyaloid from sub-ILM hemorrhage. Patterns of hemorrhages of optic nerve contribute to understanding mechanisms of Terson's syndrome.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
DESIGN: Retrospective case series with clinicopathologic correlation.
PARTICIPANTS: We included 109 deceased individuals with Terson's syndrome.
METHODS: Histologic sections and gross photographs from 109 cases of Terson's Syndrome, accessed from 1955 to 1992 at the Wm R. Green Laboratory of Ocular Pathology, were studied and photographed; a representative case is described in detail.
MAIN OUTCOME MEASURES: Abnormalities in retina and optic nerve.
RESULTS: Hemorrhages occur in vitreous, subhyaloid, sub-internal limiting membrane (ILM), intraretinal, and subretinal spaces, in association with macular holes, retinal detachments, and optic neuropathy. Subhyaloid hemorrhages have diffuse morphology, whereas sub-ILM are well-demarcated. Continuous and noncontinuous blood occurs along optic nerves, within nerve sheaths, and in the subdural and subarachnoid spaces.
CONCLUSIONS: Blood occurring in various layers and locations of the retina, particularly the macula, causes various complications that influence clinical management and visual outcome. Morphology differentiates subhyaloid from sub-ILM hemorrhage. Patterns of hemorrhages of optic nerve contribute to understanding mechanisms of Terson's syndrome.
FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
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