A Case of Terson-Like Syndrome in a Newly Diagnosed AIDS Patient with Cryptococcal Meningitis

Abstract

Introduction: Terson's syndrome has been associated with many conditions that increase intracranial pressure that leads to dilation of the retrobulbar optic nerve and compression of the central retinal vein. Materials and Methods: A 36 years old military male patient, presented with gradual visual impairment in both eyes for five days. The patient reported a history of repeated episodes of headache, fever and progressive weight loss. Best corrected visual acuity was 20/200 (RE), 20/40 (LE). Fundoscopic examination showed papilledema and multilayered retinal hemorrhages consistent with Terson syndrome. Results: The patient tested positive for HIV1. Computed tomography and magnetic resonance venography of the brain did not reveal any subdural, subarachnoid, or intracranial hemorrhages. However, cerebrospinal fluid analyses were significant for increased opening pressure and the presence of Cryptococcus Neoformans. Conclusion: It is important for ophthalmologists to be aware of the link between infectious meningitis and retinal conditions such as Terson-like syndrome because it can ease rapid diagnosis and management.