J Korean Ophthalmol Soc.  2009 Jan;50(1):167-171. 10.3341/jkos.2009.50.1.167.

Macular Pseudohypopyon in Bilateral Terson's Syndrome

• Lee DK
• Lee SJ

• KMID: 2211913
• DOI: http://doi.org/10.3341/jkos.2009.50.1.167

Abstract

PURPOSE
To report a case of a macular pseudohypopyon in the right eye in bilateral Terson's syndrome.
CASE SUMMARY
During a right eye vitrectomy of a 56-year-old female patient who showed bilateral Terson's syndrome with subarachnoid hemorrhage, a macular pseudohypopyon was observed. In an oval-shaped subinternal limiting membrane cyst (4x2 diameter size disc) including the central fovea, white exudates with fluid levels were present. The macular pseudohypopyon in the right eye was suspected to have occurred during the absorption of the subinternal limiting membrane hemorrhage. In the left eye, white exudates were clustered in the central fovea. In the right eye, the central fovea was above the fluid level of the pseudohypopyon, and corrected visual acuity was 1.0 after 6 months. Two months after the operation, the pseudohypopyon was absorbed.

Keyword

Macular pseudohypopyon; Subinternal limiting membrane hemorrhage; Terson's syndrome

MeSH Terms

Absorption
Exudates and Transudates
Eye
Female
Hemorrhage
Humans
Membranes
Middle Aged
Subarachnoid Hemorrhage
Visual Acuity
Vitrectomy

Figure

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  Figure 1. Fundus photograph of the right eye during operation. It shows a splint hemorrhage on the disc and a dense subinternal limiting membrane exudate with fluid level (pseudohypopyon).

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  Figure 2. Postoperative fundus photographs of the right eye (A) and left eye (B) after 3 weeks, and the right eye (C) and left eye (D) after 2 months. (A) The pseudohypopyon diminished at the posterior pole. (B) The wedge-shaped hemorrhage was absorbed at the posterior pole. The white exudates were presented at margin and base of previous hemorrhage. (C) The pseudohypopyon vanished at the posterior pole. (D) The dense subinternal limiting membrane exudates disappeared. However, the retinal atrophic lesion and pigmentation was found on the previous hemorrhage area.

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  Figure 3. Postoperative fundus photographs of the right eye (A) and left eye (B), and optical coherence tomography by line scanning on the macula of the right eye (C) and left eye (D) after 6 months. (A) Subretinal exudates on the macula were seen. (B) The foveal atrophic change was significant and retinal pigment epithelial thickening was noted on the macula. (C) The normal macula was observed. (D) The photoreceptor layer was lost, and retinal pigment epithelial thickening was noted on the macula.

Reference

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