Possible methods of blood entrance in Terson syndrome.

BACKGROUND AND OBJECTIVE: To present spectral domain optical coherence tomography (SD-OCT), scanning laser ophthalmoscopy, and intraoperative images showing possible pathways of blood entrance into the eye and ways in which it may spread inside the eye in Terson syndrome.

PATIENTS AND METHODS: Nine eyes of 5 patients with Terson syndrome underwent pars plana vitrectomy. Surgeries were recorded and analyzed afterward. SD-OCT and scanning laser ophthalmoscopy examinations were performed after surgery.

RESULTS: Visual acuity improved in all cases. SD-OCT three-dimensional mode improved visualization of the internal limiting membrane (ILM), possibly due to sub-ILM blood spreading detachment near the macula and optic disc. Scanning laser ophthalmoscopy revealed blood spreading along vessels and blood under the retina was observed intraoperatively.

CONCLUSION: SD-OCT, scanning laser ophthalmoscopy, and intraoperative images show that blood may enter the vitreous cavity around the retinal vessels near the optic disc. Inside the eye, the blood may spread intraretinally, sub-ILM, or along the retinal vessels.