EPIRETINAL MEMBRANES IN TERSONS-SYNDROME - A CLINICOPATHOLOGICAL STUDY

Background: Visual impairment resulting from retinal, subhyaloid, or vitreous hemorrhages in association with Tersons syndrome is often significant. The most common long-term sequelae that may result in permanent visual deficit is the formation of an epimacular membrane. Methods: This report provides clinicopathologic documentation of epiretinal membrane proliferation secondary to Tersons syndrome. Pars plana vitrectomy was performed in 16 eyes of 11 patients with Tersons syndrome. After removal of vitreous hemorrhage, epimacular membranes were found in 10 eyes (62.5%). The posterior cortical vitreous and the epiretinal tissue were examined histologically. Results: Immunostainings with glial and retinal pigment epithelial cell markers showed that the majority of cells derived form the glia. Perls staining, specific for iron, showed that the high melanic-like component contained in the histopathologic samples corresponded to degradation of blood products secondary to chronic hemorrhage. Conclusion: The high risk of epiretinal membrane formation and the toxicity of blood breakdown products over the inner retina worsen the long-term visual prognosis in Tersons syndrome. Early surgery is advocated in such cases.