{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:36Z","timestamp":1786649796351,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The aim of this experimental study was to investigate the pathogenesis of Terson syndrome (TS), which currently is controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The central retinal artery (in 39 orbits), posterior ciliary arteries (in 8 orbits), and central retinal vein (CRV in 21 orbits) were occluded in rhesus monkeys by exposing them to lateral orbitotomy. Fundus examination and fluorescein fundus angiography were performed before and immediately after cutting the vessels and serially thereafter during the follow-up period. The rationale of the experimental study design is discussed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In eyes with central retinal artery occlusion, retinal hemorrhages were seen soon after the procedure in 7 eyes, and on follow-up in a total of 15 eyes. In posterior ciliary artery occlusion, retinal hemorrhages were seen soon after the procedure in one eye, and on follow-up in a total of three eyes. In eyes with CRV, all eyes had extensive scattered retinal hemorrhages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The findings of this experimental study, and my basic, experimental, and comprehensive clinical studies on CRVO, suggest the following concept of the pathogenesis of TS: Compression of the CRV plays a crucial role in the development of TS. The CRV is compressed, as it lies in the subarachnoid space of the optic nerve sheath, by raised cerebrospinal fluid pressure and\/or accumulated blood. This results in retinal venous stasis and raised venous pressure in the retinal veins, leading to venous engorgement, rupture of the retinal capillaries and retinal hemorrhages. The clinical importance of compression of the CRV and not occlusion of CRV in TS is that optic nerve sheath decompression by opening it and releasing the blood and raised cerebrospinal fluid (CSF) pressure, would result in immediate decompressing of the CRV in the subarachnoid space and restoration of normal circulation and prevent visual loss.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_1359_22","type":"journal-article","created":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T08:53:31Z","timestamp":1670316811000},"page":"4130-4137","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":13,"title":["Pathogenesis of Terson syndrome"],"prefix":"10.4103","volume":"70","author":[{"given":"Sohan S","family":"Hayreh","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, College of Medicine, University of Iowa, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"R1-20251006","first-page":"23","article-title":"\u00dcber Einigevom Allgemein-Klinischen Standpunktaus Interessante Augenver\u00e4nderungen","volume":"18","author":"Litten","year":"1881","journal-title":"Berl Klin Wochenschr"},{"key":"R2-20251006","first-page":"309","article-title":"De l'h\u00e9morrhagie dans le corps vitr\u00e9au cours de l'h\u00e9morrhagiec\u00e9r\u00e9brale","volume":"6","author":"Terson","year":"1900","journal-title":"Clin Ophthalmol"},{"key":"R3-20251006","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.jocn.2016.04.015","article-title":"Terson's syndrome-Pathophysiologic considerations of an underestimated concomitant disease in aneurysmal subarachnoid hemorrhage","volume":"33","author":"Czorlich","year":"2016","journal-title":"J Clin Neurosci"},{"key":"R4-20251006","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1007\/s00701-016-2766-8","article-title":"Terson syndrome in aneurysmal subarachnoid hemorrhage-its relation to intracranial pressure, admission factors, and clinical outcome","volume":"158","author":"Joswig","year":"2016","journal-title":"Acta Neurochir"},{"key":"R5-20251006","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/0002-9394(66)90758-6","article-title":"The structure of the head of the optic nerve in rhesus monkey","volume":"61","author":"Hayreh","year":"1966","journal-title":"Am J Ophthalmol"},{"key":"R6-20251006","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3171\/jns.1974.41.2.0160","article-title":"Intraocular and optic nerve sheath hemorrhage in cases of sudden intracranial hypertension","volume":"41","author":"Muller","year":"1974","journal-title":"J Neurosurg"},{"key":"R7-20251006","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1007\/s00415-021-10686-4","article-title":"An explanation for Terson syndrome at last:The glymphatic reflux theory","volume":"269","author":"Kumaria","year":"2022","journal-title":"J Neurol"},{"key":"R8-20251006","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1007\/s11064-015-1581-6","article-title":"The glymphatic system:A beginner's guide","volume":"40","author":"Jessen","year":"2015","journal-title":"Neurochem Res"},{"key":"R9-20251006","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1159\/000309386","article-title":"The sheath of the optic nerve","volume":"189","author":"Hayreh","year":"1984","journal-title":"Ophthalmologica"},{"key":"R10-20251006","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.preteyeres.2015.10.001","article-title":"Pathogenesis of optic disc edema in raised intracranial pressure","volume":"50","author":"Hayreh","year":"2016","journal-title":"Prog Retin Eye Res"},{"key":"R11-20251006","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1136\/bjo.49.12.626","article-title":"Occlusion of the central retinal vessels","volume":"49","author":"Hayreh","year":"1965","journal-title":"Br J Ophthalmol"},{"key":"R12-20251006","first-page":"621","article-title":"Central retinal vein occlusion. 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