左視力低下を主訴に眼科初診で発見されたテルソン症候群の1例

A case of Terson's syndrome diagnosed at the first visit to an ophthalmologist with a complaint of left visual loss

要約　目的：左視力低下を主訴に眼科初診で発見されたテルソン症候群の1例の報告。

症例：46歳，男性。突然の左視力低下を主訴に近医眼科を経て当科を初診した。初診時視力は右（1.2），左（0.3），右眼に斑状の網膜出血，左眼に網膜出血，内境界膜下出血，少量の硝子体出血を認めた。頭部単純CTでくも膜下出血を認め，テルソン症候群と診断した。脳神経外科にて脳動脈瘤クリッピング術を施行された。両網膜出血および左硝子体出血は自然消退し，術後約2か月時には右1.2，左1.0と著明な視力改善を認めた。

結論：神経学的症状に乏しくとも，原因不明の網膜出血および硝子体出血を認めた際にはテルソン症候群の可能性も念頭に置くべきである。

Abstract　Purpose：To report a case of Terson's syndrome diagnosed at the first visit to an ophthalmologist with complaint of left visual loss.

Case and Findings：A 46-year-old man was referred to us for complaint of sudden left visual loss. His corrected visual acuity was 1.2（right）and 0.3（left）. His right eye showed a blot retinal hemorrhage and left eye showed retinal hemorrhage, subinternal limiting membrane hemorrhage, and vitreous hemorrhage. Computed tomography showed subarachnoid hemorrhage. He was diagnosed with Terson's syndrome and was treated with clipping surgery by neurosurgeons. Bilateral retinal hemorrhages and left vitreous hemorrhage regressed 2 months after surgery. The visual acuity was recovered to 1.2（right）and 1.0（left）.

Conclusion：The possibility of Terson's syndrome should be considered in cases with unexplained retinal and vitreous hemorrhages even if there are few neurological manifestations.