gms | German Medical Science

Background: Intracranial hemorrhages are followed by vitreous hemorrhages in 5% (Terson’s Syndrom). A pars plana vitrectomy (PPV) is performed, when the vitreous hemorrhage persists or tractions develop. As many patients still require neurological inpatient treatment at the time of PPV, we performed the PPV as an outpatient treatment in most cases and referred them back for further neurological rehabilitation. Therefore we usually had no follow up in our department. To analyze the long term anatomical and functional results and the further neurological development, we collected data from the neurologists and the eye doctors who did the follow up.

Methods: We analyzed the records of 32 patients, who had surgery for Terson’s syndrom between Jan 1, 1996 and April 30th, 2004.

Results: PPV was performed 12.2 weeeks after the intracranial hemorrhage. 11/32 patients developed bilateral hemorrhages, 6 had bilateral PPV, 5 died, before the PPV could be carried out in the second eye. Visual acuity rose from LogMAR 1.9 preoperatively (fingercounting) to LogMAR 0.551 (Snellen VA 0.3) 6 months after surgery to LogMAR 0.148 at 1 year. and LogMAR 0.179 (each is about 0.7) 3 years following surgery. PPV enabled rapid further neurological rehabilitation: preoperatively 63% could neither walk with or without assistance and had to rely on a wheel chair. Only 39% had to do so at 6 weeks postop, 36% at 6 months postop, 32% at 1 year and 30% at 3 years.

Conclusion: PPV for Terson’s syndrom can be successfully performed as an outpatient procedure with a low complication rate. The eye surgery fastens the neurological rehabilitation process.