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Jan Regelsberger - One of the best experts on this subject based on the ideXlab platform.

  • RESEARCH ARTICLE Ocular Ultrasound as an Easy Applicable Tool for Detection of Terson’s Syndrome
    2016
    Co-Authors: After Aneurysmal Subarachnoid, Patrick Czorlich, Volker Knospe, Lars Wagenfeld, Manfred Westphal, Till Burkhardt, Gisbert Richard, Jan Regelsberger
    Abstract:

    . These authors contributed equally to this work. Introduction: Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson’s syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson’s syndrome

  • terson syndrome in subarachnoid Hemorrhage intracerebral Hemorrhage and traumatic brain injury
    Neurosurgical Review, 2015
    Co-Authors: Patrick Czorlich, Christos Skevas, Volker Knospe, Eik Vettorazzi, G Richard, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger
    Abstract:

    This prospective trial was designed to evaluate the incidence of Terson syndrome in patients suffering from subarachnoid Hemorrhage, intracerebral Hemorrhage, or traumatic brain injury and whether consequences necessarily derive from the Intraocular Hemorrhage itself. Two ophthalmologic examinations were performed to identify patients with Terson syndrome. Data on initial Glasgow Coma Scale, Hunt and Hess and Fisher grades, aneurysm site and diameter, and volume of Hemorrhage in intracerebral Hemorrhage patients were correlated to the location and course of Terson syndrome. Follow-up was performed after 3 months, including clinical and ophthalmologic investigations. The data showed that 16 of 83 subarachnoid Hemorrhage patients (19.3 %), 2 of 22 intracerebral Hemorrhage patients (9.1 %), and 1 of 32 traumatic brain injury patients (3.1 %) suffered from Terson syndrome. Low Glasgow Coma Scale (p = 0.002), high Hunt and Hess grade (p < 0.001), and high Fisher grade (p = 0.002) were found to be associated with a higher incidence of Terson syndrome. The neurological outcome in subarachnoid Hemorrhage patients suffering from Terson syndrome was worse compared with that of subarachnoid Hemorrhage patients without Terson syndrome (p = 0.005), and vitrectomy was performed in seven eyes of six patients due to poor visual acuity. Terson syndrome is underestimated in patients with subarachnoid Hemorrhage and a rare pathology in intracerebral Hemorrhage as well as in traumatic brain injury patients. Spontaneous regression of the Intraocular Hemorrhage may be seen, but in half of the patients, vitrectomy is necessary to prevent permanent visual deterioration.

  • Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid Hemorrhage
    PloS one, 2014
    Co-Authors: Patrick Czorlich, Volker Knospe, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, Till Burkhardt, Gisbert Richard, Christos Skevas
    Abstract:

    Introduction Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome. Material and Methods Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid Hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an Intraocular Hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an Intraocular Hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound. Results Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid Hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of Intraocular Hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome. Conclusions Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome.

  • Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid Hemorrhage.
    Public Library of Science (PLoS), 1
    Co-Authors: Patrick Czorlich, Volker Knospe, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, Till Burkhardt, Gisbert Richard, Christos Skevas
    Abstract:

    Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome.Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid Hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an Intraocular Hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an Intraocular Hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound.Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid Hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of Intraocular Hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome.Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome

Christos Skevas - One of the best experts on this subject based on the ideXlab platform.

  • terson syndrome in subarachnoid Hemorrhage intracerebral Hemorrhage and traumatic brain injury
    Neurosurgical Review, 2015
    Co-Authors: Patrick Czorlich, Christos Skevas, Volker Knospe, Eik Vettorazzi, G Richard, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger
    Abstract:

    This prospective trial was designed to evaluate the incidence of Terson syndrome in patients suffering from subarachnoid Hemorrhage, intracerebral Hemorrhage, or traumatic brain injury and whether consequences necessarily derive from the Intraocular Hemorrhage itself. Two ophthalmologic examinations were performed to identify patients with Terson syndrome. Data on initial Glasgow Coma Scale, Hunt and Hess and Fisher grades, aneurysm site and diameter, and volume of Hemorrhage in intracerebral Hemorrhage patients were correlated to the location and course of Terson syndrome. Follow-up was performed after 3 months, including clinical and ophthalmologic investigations. The data showed that 16 of 83 subarachnoid Hemorrhage patients (19.3 %), 2 of 22 intracerebral Hemorrhage patients (9.1 %), and 1 of 32 traumatic brain injury patients (3.1 %) suffered from Terson syndrome. Low Glasgow Coma Scale (p = 0.002), high Hunt and Hess grade (p < 0.001), and high Fisher grade (p = 0.002) were found to be associated with a higher incidence of Terson syndrome. The neurological outcome in subarachnoid Hemorrhage patients suffering from Terson syndrome was worse compared with that of subarachnoid Hemorrhage patients without Terson syndrome (p = 0.005), and vitrectomy was performed in seven eyes of six patients due to poor visual acuity. Terson syndrome is underestimated in patients with subarachnoid Hemorrhage and a rare pathology in intracerebral Hemorrhage as well as in traumatic brain injury patients. Spontaneous regression of the Intraocular Hemorrhage may be seen, but in half of the patients, vitrectomy is necessary to prevent permanent visual deterioration.

  • Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid Hemorrhage
    PloS one, 2014
    Co-Authors: Patrick Czorlich, Volker Knospe, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, Till Burkhardt, Gisbert Richard, Christos Skevas
    Abstract:

    Introduction Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome. Material and Methods Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid Hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an Intraocular Hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an Intraocular Hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound. Results Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid Hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of Intraocular Hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome. Conclusions Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome.

  • Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid Hemorrhage.
    Public Library of Science (PLoS), 1
    Co-Authors: Patrick Czorlich, Volker Knospe, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, Till Burkhardt, Gisbert Richard, Christos Skevas
    Abstract:

    Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome.Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid Hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an Intraocular Hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an Intraocular Hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound.Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid Hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of Intraocular Hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome.Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome

Patrick Czorlich - One of the best experts on this subject based on the ideXlab platform.

  • RESEARCH ARTICLE Ocular Ultrasound as an Easy Applicable Tool for Detection of Terson’s Syndrome
    2016
    Co-Authors: After Aneurysmal Subarachnoid, Patrick Czorlich, Volker Knospe, Lars Wagenfeld, Manfred Westphal, Till Burkhardt, Gisbert Richard, Jan Regelsberger
    Abstract:

    . These authors contributed equally to this work. Introduction: Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson’s syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson’s syndrome

  • terson syndrome in subarachnoid Hemorrhage intracerebral Hemorrhage and traumatic brain injury
    Neurosurgical Review, 2015
    Co-Authors: Patrick Czorlich, Christos Skevas, Volker Knospe, Eik Vettorazzi, G Richard, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger
    Abstract:

    This prospective trial was designed to evaluate the incidence of Terson syndrome in patients suffering from subarachnoid Hemorrhage, intracerebral Hemorrhage, or traumatic brain injury and whether consequences necessarily derive from the Intraocular Hemorrhage itself. Two ophthalmologic examinations were performed to identify patients with Terson syndrome. Data on initial Glasgow Coma Scale, Hunt and Hess and Fisher grades, aneurysm site and diameter, and volume of Hemorrhage in intracerebral Hemorrhage patients were correlated to the location and course of Terson syndrome. Follow-up was performed after 3 months, including clinical and ophthalmologic investigations. The data showed that 16 of 83 subarachnoid Hemorrhage patients (19.3 %), 2 of 22 intracerebral Hemorrhage patients (9.1 %), and 1 of 32 traumatic brain injury patients (3.1 %) suffered from Terson syndrome. Low Glasgow Coma Scale (p = 0.002), high Hunt and Hess grade (p < 0.001), and high Fisher grade (p = 0.002) were found to be associated with a higher incidence of Terson syndrome. The neurological outcome in subarachnoid Hemorrhage patients suffering from Terson syndrome was worse compared with that of subarachnoid Hemorrhage patients without Terson syndrome (p = 0.005), and vitrectomy was performed in seven eyes of six patients due to poor visual acuity. Terson syndrome is underestimated in patients with subarachnoid Hemorrhage and a rare pathology in intracerebral Hemorrhage as well as in traumatic brain injury patients. Spontaneous regression of the Intraocular Hemorrhage may be seen, but in half of the patients, vitrectomy is necessary to prevent permanent visual deterioration.

  • Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid Hemorrhage
    PloS one, 2014
    Co-Authors: Patrick Czorlich, Volker Knospe, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, Till Burkhardt, Gisbert Richard, Christos Skevas
    Abstract:

    Introduction Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome. Material and Methods Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid Hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an Intraocular Hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an Intraocular Hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound. Results Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid Hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of Intraocular Hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome. Conclusions Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome.

  • Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid Hemorrhage.
    Public Library of Science (PLoS), 1
    Co-Authors: Patrick Czorlich, Volker Knospe, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, Till Burkhardt, Gisbert Richard, Christos Skevas
    Abstract:

    Intraocular Hemorrhage in patients suffering from aneurysmal subarachnoid Hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome.Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid Hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an Intraocular Hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an Intraocular Hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound.Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid Hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of Intraocular Hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome.Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome

Fang Zhou - One of the best experts on this subject based on the ideXlab platform.

  • Clinical observations and considerations in the treatment of Terson syndrome using 23G vitrectomy.
    International ophthalmology, 2020
    Co-Authors: Chao Huang, Hong Kyungwan, Fang Zhou
    Abstract:

    PURPOSE This retrospective study analyzed the results of 23G vitrectomy for the treatment of Intraocular Hemorrhage in patients with Terson syndrome. The pathogenesis of Terson syndrome and the timing of vitrectomy are discussed. METHODS Eight eyes of eight patients were included in the study. Intrasurgical images were acquired, and membranes peeled off during surgery were subjected to pathological staining. Postoperative examination included visual acuity, Intraocular pressure, funduscopy, and optical coherence tomography angiography. RESULTS The course of visual impairment in the patients ranged from 

  • clinical observations and considerations in the treatment of terson syndrome using 23g vitrectomy
    International Ophthalmology, 2020
    Co-Authors: Chao Huang, Hong Kyungwan, Fang Zhou
    Abstract:

    PURPOSE This retrospective study analyzed the results of 23G vitrectomy for the treatment of Intraocular Hemorrhage in patients with Terson syndrome. The pathogenesis of Terson syndrome and the timing of vitrectomy are discussed. METHODS Eight eyes of eight patients were included in the study. Intrasurgical images were acquired, and membranes peeled off during surgery were subjected to pathological staining. Postoperative examination included visual acuity, Intraocular pressure, funduscopy, and optical coherence tomography angiography. RESULTS The course of visual impairment in the patients ranged from < 1 to 5 months; visual acuity ranged from light perception to 20/1000. Surgeries in the eight patients were all successful, and no severe complications were observed. Visual acuity improved in each operative eye. Pathological staining revealed only fibrous connective tissue, and no nerve fibers in the membranes peeled off during surgery. Optical coherence tomography angiography revealed no changes in blood vessel density in the inner layer of the retina of the operative eye compared with the non-operative eye in each patient. CONCLUSIONS Timely surgical intervention is necessary for the treatment of Intraocular Hemorrhage in patients with Terson syndrome. Clinical findings support the theory that Intraocular blood results from stasis or rupture of retinal superficial peripapillary vessels caused by elevated intracranial pressure.

Steven J. Gedde - One of the best experts on this subject based on the ideXlab platform.

  • Bilateral Intraocular Hemorrhage from vascularization of cataract wounds.
    Journal of cataract and refractive surgery, 2009
    Co-Authors: Michael R. Banitt, Allison Rand, Robin R. Vann, Steven J. Gedde
    Abstract:

    We report a case of bilateral Intraocular Hemorrhage from vascularization of cataract wounds. The patient experienced decreased vision following an episode of vomiting more than 2.5 years after phacoemulsification through a scleral tunnel incision in the right eye and combined trabeculectomy and extracapsular cataract extraction in the left eye. Gonioscopy demonstrated abnormal vessels in the region of the cataract wound superiorly and small hyphemas inferiorly in both eyes. The Hemorrhages and elevated Intraocular pressure normalized over weeks. The left eye had a recurrent Hemorrhage 5 months later, which was successfully treated with argon laser goniophotocoagulation.