The ocular pathology of Terson's syndrome.

PURPOSE To improve understanding of vision loss and clinical findings, we studied gross and microscopic pathology of retinas and optic nerves of individuals with Terson's syndrome. DESIGN Retrospective case series with clinicopathologic correlation. PARTICIPANTS We included 109 deceased individuals with Terson's syndrome. METHODS Histologic sections and gross photographs from 109 cases of Terson's Syndrome, accessed from 1955 to 1992 at the Wm R. Green Laboratory of Ocular Pathology, were studied and photographed; a representative case is described in detail. MAIN OUTCOME MEASURES Abnormalities in retina and optic nerve. RESULTS Hemorrhages occur in vitreous, subhyaloid, sub-internal limiting membrane (ILM), intraretinal, and subretinal spaces, in association with macular holes, retinal detachments, and optic neuropathy. Subhyaloid hemorrhages have diffuse morphology, whereas sub-ILM are well-demarcated. Continuous and noncontinuous blood occurs along optic nerves, within nerve sheaths, and in the subdural and subarachnoid spaces. CONCLUSIONS Blood occurring in various layers and locations of the retina, particularly the macula, causes various complications that influence clinical management and visual outcome. Morphology differentiates subhyaloid from sub-ILM hemorrhage. Patterns of hemorrhages of optic nerve contribute to understanding mechanisms of Terson's syndrome. FINANCIAL DISCLOSURE(S) The authors have no proprietary or commercial interest in any of the materials discussed in this article.