PDF(Pubmed)
Abstract：
Terson syndrome refers to intraocular haemorrhage that occurs due to subarachnoid bleeding associated with an acute increase in intracranial pressure. No previous study has reported a delayed macular hole (MH) secondary to Terson syndrome. A 17-year-old boy visited our department and presented with vitreous bleeding and a history of subarachnoid haemorrhage. Sub-internal limiting membrane (ILM) haemorrhage with ILM detachment and intraretinal haemorrhage were detected during pars plana vitrectomy. Additionally, a delayed MH was detected 1 week after the surgery. There was no sign of MH closure during a 2-month follow-up. Subsequently, an MH massage was performed to close the MH. Our findings suggest that a delayed MH can occur secondary to Terson syndrome. Elevated hydrodynamic pressure and hydrostatic pressure, which are caused by sub-ILM and intraretinal haemorrhages of the fovea, contribute to the formation of an MH. Additionally, ILM peeling may cause damage to the macula and facilitate the formation of MHs. Although the MH may close by itself, early surgical intervention is recommended when there is no sign that the MH will close spontaneously because a prolonged MH can lead to retinal damage.
摘要：
Terson综合征是指由于与颅内压急性升高相关的蛛网膜下腔出血而发生的眼内出血。以前没有研究报道继发于Terson综合征的延迟性黄斑裂孔(MH)。一个17岁的男孩来了我们的部门，并出现了玻璃体出血和蛛网膜下腔出血的病史。在平坦部玻璃体切除术中检测到亚内界膜（ILM）出血，ILM脱离和视网膜内出血。此外,术后1周发现延迟MH.在2个月的随访中没有MH关闭的迹象。随后，进行MH按摩以关闭MH。我们的发现表明，延迟的MH可继发于Terson综合征。升高的动水压力和静水压力，这是由亚ILM和视网膜窝出血引起的，有助于MH的形成。此外,ILM剥离可能导致黄斑损伤并促进MHs的形成。尽管MH可能会自行关闭，当没有迹象表明MH会自发关闭时,建议进行早期手术干预,因为MH时间延长会导致视网膜损伤.
