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Can baseline computerized tomography scans be used to idenfity patients at high risk of vision loss due to Terson syndrome?

American Journal of Ophthalmology Oct 09, 2019

Stewart MW, Hasan SA, Collins C, et al. - Among 117 patients with aneurysmal subarachnoid hemorrhages (aSAH), researchers ascertained whether routinely performed CT scanning was sufficient to diagnose patients at high risk of vision loss due to Terson syndrome (TS). Consecutive patients with aSAH diagnosis admitted to the Neurological Intensive Care Unit of a regional referral hospital were prospectively assessed over a period of 3 years. They categorized retinal hemorrhages by size - those smaller than 2 mm in diameter were considered low risk (lrTS) for vision loss and those greater than 2 mm in diameter were considered high risk (hrTS) for vision loss. Data reported that the overall incidence of TS was 24.9%. Patients with TS had a higher Fisher Hemorrhage Grade and a lower mean (+ standard deviation) Glasgow Coma Score (8.66 + 4.97 vs. 12.09 + 1.10) vs those without TS. For diagnosing hrTS, the CT crescent sign was highly sensitive (85.7%) and specific (99.1%). To identify patients at risk of vision loss due to aSAH, CT scanning can replace routine ophthalmologic examinations.
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