Dissociated optic nerve fiber layer in a case of Terson syndrome

2019 ◽  
Vol 30 (5) ◽  
pp. NP11-NP14
Author(s):  
Koushik Tripathy

Purpose: To report a case of Terson syndrome who developed dissociated optic nerve fiber layer appearance after pars plana vitrectomy. Case report: The author reports a young male patient with Terson syndrome who developed bilateral vitreous hemorrhage and sub-internal limiting membrane hemorrhage after road traffic accident. He underwent pars plana vitrectomy and removal of the already detached internal limiting membrane and the sub-internal limiting membrane hemorrhage in both eyes. In both eyes, dissociated optic nerve fiber layer was appreciated and left eye had a peculiar resemblance to the appearance of cystoid macular edema. Conclusions: Dissociated optic nerve fiber layer appearance may be noted following vitrectomy and removal of detached internal limiting membrane in patients with vitreous hemorrhage and sub-internal limiting membrane bleed due to Terson syndrome.

2021 ◽  
Vol 22 (4) ◽  
pp. 1724
Author(s):  
Tsunehiko Ikeda ◽  
Kimitoshi Nakamura ◽  
Takaki Sato ◽  
Teruyo Kida ◽  
Hidehiro Oku

Dissociated optic nerve fiber layer (DONFL) appearance is characterized by dimpling of the fundus when observed after vitrectomy with the internal limiting membrane (ILM) peeling in macular diseases. However, the cause of DONFL remains largely unknown. Optical coherence tomography (OCT) findings have indicated that the nerve fiber layer (NFL) and ganglion cells are likely to have been damaged in patients with DONFL appearance. Since DONFL appearance occurs at a certain postoperative period, it is unlikely to be retinal damage directly caused by ILM peeling because apoptosis occurs at a certain period after tissue damage and/or injury. However, it may be due to ILM peeling-induced apoptosis in the retinal tissue. Anoikis is a type of apoptosis that occurs in anchorage-dependent cells upon detachment of those cells from the surrounding extracellular matrix (i.e., the loss of cell anchorage). The anoikis-related proteins βA3/A1 crystallin and E-cadherin are reportedly expressed in retinal ganglion cells. Thus, we theorize that one possible cause of DONFL appearance is ILM peeling-induced anoikis in retinal ganglion cells.


Retina ◽  
2003 ◽  
Vol 23 (4) ◽  
pp. 561-563 ◽  
Author(s):  
MASAHIRO MIURA ◽  
ANN E. ELSNER ◽  
MASAHIRO OSAKO ◽  
TAKUYA IWASAKI ◽  
TADASHI OKANO ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document