Objective To investigate the incidence, risk factors and relationship with intraocular hemorrhage of Terson prime;s syndrome among patients with spontaneous subarachnoid hemorrhage (SSAH) after emergency admission. Methods Seventy-four consecutive patients with SSAH from June 2010 to September 2011 were prospectively examined. A direct ophthalmoscope examination was performed in all participants within three hours after emergency admission. If circumstances permit, fundus photos were taken. When initial fundus examination was conducted, the Hunt-Hess grade was classified by the brain surgeon. The fundus examination was taken on the 1st, 3rd, and 7th day, 2 weeks, 1 month, and 3 months after emergency admission. The details were recorded, including sex, age, bleeding patterns, Hunt-Hess grade and death. The incidence of Terson prime;s syndrome was analyzed and correlated with sex, age and Hunt-Hess grade. The relationship between intraocular hemorrhage and Hunt-Hess grade and mortality was analyzed. Results Among the 74 patients, 19 were suffering from Terson prime;s syndrome, 31 eyes involved. The incidence of Terson prime;s syndrome was 25.7%. Statistical analysis demonstrated that the sex of the patient was randomly distributed ( chi;2=0.071,P=0.790), and the age components were also randomly distributed (Fisher prime;s exact test.P=0.203). The Hunt-Hess grade components were nonrandomly distributed (Fisher prime;s exact test，P=0.000). Among the patients with preretinal hemorrhage and vitreous hemorrhage, Hunt-Hess grade Ⅴ was in 76.9% patients; among inte-retinal hemorrhage, Hunt-Hess grade was in 16.7% of patients. The distribution was non-random (Fisher prime;s exact test.P=0.041). All intraocular hemorrhages were found at the time of first fundus examination. The mortality from Terson prime;s syndrome was 68.4% (13/19) according to the follow-up investigation. The mortality in patients with vitreous hemorrhage and preretinal hemorrhage was statistically different (Fisher prime;s exact test.P=0.046) from patients with inter-retinal hemorrhage. Among the six recovered Terson prime;s syndrome patients, two of them were recovered from vitrectomy, and the other four were recovered from selfabsorption. Conclusion s A higher frequency (25.7%) of Terson prime;s syndrome was observed in patients with SSAH. The incidence is highly related to the general condition of the patient but not to the sex or age. Intraocular hemorrhage is more likely to happen in the early time of SSAH. People with more severe intraocular hemorrhage may have worse general condition or higher mortality.
Citation： 杨乾军,毛剑波,尹波,佘相均,曹婵媛,沈丽君. Clinical research of Terson′s syndrome among spontaneous subarachnoid hemorrhage patients at emergency admission. Chinese Journal of Ocular Fundus Diseases, 2013, 29(4): 392-395. doi: Copy