Background  

A premacular accumulation of blood is termed a hemorrhagic macular cyst and may be found both in eyes with Tersons syndrome and in shaken baby syndrome. In this study, we report on our experience and results of vitreoretinal surgery for treatment of premacular hemorrhagic cyst in eyes of patients suffering from Tersons syndrome and shaken baby syndrome.

Patients and methods  

Between November 1995 and May 2003 seven eyes of six children underwent vitrectomy for premacular hemorrhagic cyst. Patients age ranged from 5 months to 17 years. Indication for vitreoretinal surgery was premacular hemorrhagic cyst in eyes with Tersons syndrome (n=5) and shaken baby syndrome (n=2). During vitrectomy, rhexis of internal limiting membrane was performed. Four children received intensive orthoptic treatment postoperatively.

Results  

All eyes in our series showed a submembranous localization of premacular hemorrhagic cyst. The results of electron microscopic examination showed that the excised anterior walls contain internal limiting membrane. In all eyes improvement of the anatomic situation and of visual acuity was achieved. Duration of follow-up ranged from 6 months to 5 years.

Conclusions  

Vitrectomy for hemorrhagic macular cyst in children is a safe and effective alternative to observation, offering visual rehabilitation, especially if amblyopia has developed or if both eyes are affected. If a hemorrhagic macular cyst is encountered, its complete removal is recommended to prevent development of proliferative vitreoretinopathy.