Terson综合征13例的临床疗效分析

目的：探讨Terson综合征患者的临床治疗效果。方法：Terson综合征13例19眼，术前视力光感～0.02，病程1~15(平均7.7)mo。行玻璃体切割术，术中根据玻璃体视网膜情况，采用玻璃体腔内硅油填充2眼，采用气体填充1眼，余采用玻璃体切割灌注液填充。结果：术中发现玻璃体出血集中在后极部占多数；视网膜前出血12眼（两眼基本对称），出血在黄斑区4眼，多灶性出血3眼。首次术后19眼视力显著提高，无黄斑区视网膜前出血12眼视力提高到0.4～1.0(平均0.6)；有黄斑区视网膜前出血4眼视力提高到0.02～0.4(平均0.3)。前者较后者术后视力显著提高 (P<0.05)。术后随访15眼，约3～26(平均17.6)mo。术后发生视网膜脱离2眼，再次行视网膜复位术。结论：Terson综合征患者及时行玻璃体视网膜手术安全有效，无黄斑区视网膜前出血较有黄斑区视网膜前出血的患者视力恢复明显。

Clinical effect analysis of Terson syndrome in 13 cases

AIM:To evaluate the clinical effects of Terson syndrome. METHODS:Thirteen cases(19 eyes)of Terson syndrome had preoperative visual acuity (VA) from light perception to 0.02, and duration of 1-15 (average 7.7) months. Vitrectomy was performed.In accordance with the vitreo-retinal circumstances, silicone oil tamponade was performed on 2 eyes, gas filling on 1 eye,others were filled with vitrectomy perfusate. RESULTS:Majority of vitreous hemorrhage was found concentrated in the posterior pole; preretinal hemorrhage occurred in 12 eyes( symmetrical in two eyes), hemorrhage in the macular area in 4 eyes, multi-focal hemorrhage in 3 eyes.After the first operation, VA in 19 eyes significantly increased, VA in 12 eyes without macular preretinal hemorrhage increased to 0.4-1.0 (average 0.6); VA in 4 eyes with macular preretinal hemorrhage increased to 0.02-0.4 (average 0.3).The former significantly increased in VA than the latter (P<0.05). Postoperative follow-up on 15 eyes lasted for 3 to 26 (mean 17.6) months. Postoperative retinal detachment occurred in 2 eyes, which got satisfactory result from retinal reattachment surgery. CONCLUSION:Timely vitreoretinal surgery is safe and effective for Terson syndrome patients. Visions in patients without macular preretinal hemorrhage are restored better than those with macular preretinal hemorrhage.