Analysis Of The Features Of The Development, Clinical Course And Surgical Treatment Of Haemophthalmus In Terson`S Syndrome

Terson syndrome (TS) is associated with impaired retinal microcirculation as a result of increased intracranial pressure after cerebral hemorrhage, ultimately leading to venous hypertension and hemophthalmos.

The purpose of our research was to determine the features of the development, clinical course and surgical treatment of hemophthalmos in Terson's syndrome.

40 patients (80 eyes), including 18 women and 22 men, aged 18 to 75 years, with ICH were under observation. If the treatment was ineffective for 4-5 weeks, we performed surgical intervention. The surgical intervention was carried out in the scope of a closed subtotal vitrectomy (SVT) 23/27ga with removal of the ILM and endotamponade with a gas-air mixture. The frequency of CT was analyzed taking into account gender, age, cause of HF, presence of coma in the anamnesis, and the fact of neurosurgery. The localization of hemorrhage during CT 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 higher in women than in men, in patients aged 30 to 60 years, as well as among cases of non-traumatic IHD. We found that coma and a history of neurosurgery 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 was required in 60% of cases. We found a statistically significant improvement in visual function after surgery. The complication rate was 16.6% 2 weeks after surgery, 8.3% - 1 month, and 25% - 6 months. We recorded a single case of recurrence of hemophthalmus, which was associated with late postoperative complications.

The results of our study complement the data published in the literature about the peculiarities of the occurrence, clinical course and treatment of ST, and confirm that surgical intervention for hemophthalmia 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.