Page 166 - A Magyar Szemorvostársaság 2023. évi kongresszusa - Tudományos program és előadáskivonatok

Patient and Methods: 13-year-old male child consulted in the paediatric ophthalmology
department of our clinic. Four months previously, he had a bleeding of a previously unknown
arteriovenous malformation located in right parietal lobe requiring immediate life-saving
intervention. After neurosurgical surgery and intensive care unit treatment, he presented with
residual symptoms of haemorrhagic stroke and limited mobility.

Routine ophthalmologic and neuroophthalmologic examinations were performed to investigate
his bilateral visual impairment. During follow-up, his condition was monitored by regular
ophthalmic ultrasound and Goldmann visual field testing. Imaging examinations were
organised and performed by colleagues in co-specialties.

Results and follow-up: At the first examination, the child's best corrected visual acuity was HM
in the right and 1.0 in the left eye, with homonymous hemianopia in the left visual field Slit-
lamp examination revealed a fine, linear corneal scar below the centre in both eyes. Fundus
examination of the right eye showed a severe haemorrhage into the vitreous cavity, while
ultrasonography showed the retina to be attached. The posterior segment of the left eye was
found to be intact.

We concluded Terson's syndrome in addition to visual field loss due to the underlying disease.

During one year of follow-up, the vitreous hemorrhage was only partially resolved and
eventually vitrectomy had to be performed.

After surgery, our patient's visual acuity became 1,0. His visual field loss did not change.

Conclusion: Central nervous system injuries can cause ophthalmic problems by multiple
mechanisms. In many cases, we need to use diagnostic and therapeutic methods from all
ophthalmic subspecialties to achieve the best possible outcome in our patients.