Vitreous hemorrhage in patients with high-risk retinopathy of prematurity

• Published in: American journal of ophthalmology 2003-08, Vol.136 (2), p.258-263
• Main Authors: Hutcheson, Kelly A, Nguyen, Ahn T.Q, Preslan, Mark W, Ellish, Nancy J, Steidl, Scott M
• Format: Article
• Language: English
• Subjects: Associated diseases and complications; Biological and medical sciences; Birth Weight; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Gestational Age; Humans; Infant, Newborn; Medical sciences; Ophthalmology; Prognosis; Refraction, Ocular; Retinal Detachment - etiology; Retinopathies; Retinopathy of Prematurity - complications; Retinopathy of Prematurity - physiopathology; Retrospective Studies; Risk Factors; Visual Acuity; Vitreous Hemorrhage - etiology; Vitreous Hemorrhage - physiopathology
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(03)00190-9

To investigate outcomes in premature infants with high-risk retinopathy of prematurity and secondary vitreous hemorrhage. Retrospective chart review. Patients were selected from a database of infants undergoing retinopathy of prematurity screening from September 1997 to November 1999. Infants with high-risk retinopathy of prematurity (zone I or posterior zone II threshold disease) with and without vitreous hemorrhage were compared. Final stage of retinopathy of prematurity and short-term structural outcome were assessed. Visual acuity and refraction were measured when possible. Twenty-two eyes of 11 patients (group 1) had high-risk (posterior zone II or zone I threshold) retinopathy of prematurity without vitreous hemorrhage. Group 1 patients had a 91% favorable short-term structural outcome. Eight eyes of five infants developed vitreous hemorrhage with high-risk retinopathy of prematurity (group 2). Group 2 patients had only a 12.5% favorable short-term structural outcome. Seven of eight (87.5%) progressed to stage IVa or IVb retinopathy of prematurity. Six eyes underwent vitreoretinal surgery after a median duration of hemorrhage of 36 ± 29 days (4–70 days). Three eyes developed stage V detachments and three progressed to phthisical degeneration. Final visual acuity was no light perception in three eyes. Vitreous hemorrhage, in association with advanced retinopathy of prematurity, is a poor prognostic sign.