Infantile retinal hemorrhage
Updates to Article Attributes
INTRODUCTION
Retinal hemorrhages occur when blood leaks from retinal veins or capillaries into the surrounding retinal tissue.
Retinal hemorrhages are usually diagnosed by ophthalmologists, but they may be seen by ER, ICU, or hospitalist physicians. They are occasionally seen on MR SWI imaging.
TERMINOLOGY
Terminology
Retinal hemorrhages that are associated with intracranial hemorrhage, usually subarachnoid hemorrhage, are called 'Terson Syndrome', as described by Terson in 19121900 (he actually desecribed the association between vitreous hemorrhage and intracranial hemorrhage). Another common term used in fundus hemorrhage.
EPIDEMIOLOGY
Epidemiology
The only well-known prevalenceincidence of infantile retinal hemorrhage comes from neonatal studies, where, in a recent study, 20% of full term newborns were found to have retinal hemorrhages.1
Clinical Presentation
Retinal hemorrhages are usually found in the setting of an acute infantile neurologic problem, such as seizure, lethargy, suspected or known head trauma.
Pathology
Retinal hemorrhages can appear to the ophthalmologist in various shapes depending on the layer(s) of the retina affected. They have been described as dot/blot, boat shaped, flame shaped, or splinter shaped.
Radiographic features
Retinal hemorrhages can be seen on MR SWI imaging 2.
Treatment and Prognosis
Retinal hemorrhages usually resolve on their own within weeks of diagnosis. Severe hemorrhages can cause permanent visual loss.
Practical Points
Birth related hemorrhages are typically gone by age 1 month. After that, infantile retinal hemorrhages are commonly associated with abusive head trauma, however they can occur with other conditions that cause increased intracranial pressure or intracranial hemorrhage such as accidental trauma or asphyxiation, cerebral venous thrombosis, stroke, and encephalitis.
-<p>INTRODUCTION</p><p>Retinal hemorrhages occur when blood leaks from retinal veins or capillaries into the surrounding retinal tissue.</p><p>Retinal hemorrhages are usually diagnosed by ophthalmologists, but they may be seen by ER, ICU, or hospitalist physicians. They are occasionally seen on MR SWI imaging. </p><p>TERMINOLOGY</p><p>Retinal hemorrhages that are associated with intracranial hemorrhage, usually subarachnoid hemorrhage, are called 'Terson Syndrome', as described by Terson in 1912. Another common term used in fundus hemorrhage.</p><p>EPIDEMIOLOGY</p><p>The only well-known prevalence of retinal hemorrhage comes from neonatal studies, where, in a recent study, 20% of full term newborns were found to have retinal hemorrhages.</p>- +<p><strong>Retinal hemorrhages</strong> occur when blood leaks from retinal capillaries into the surrounding retinal tissue.</p><p>Retinal hemorrhages are usually diagnosed by ophthalmologists, but they may be seen by ER, ICU, or hospitalist physicians. They are occasionally seen on MR SWI imaging. </p><h5>Terminology</h5><p>Retinal hemorrhages that are associated with intracranial hemorrhage, usually subarachnoid hemorrhage, are called 'Terson Syndrome', as described by Terson in 1900 (he actually desecribed the association between vitreous hemorrhage and intracranial hemorrhage). Another common term used in fundus hemorrhage.</p><h5>Epidemiology</h5><p>The only well-known incidence of infantile retinal hemorrhage comes from neonatal studies, where, in a recent study, 20% of full term newborns were found to have retinal hemorrhages.<sup>1</sup></p><h5>Clinical Presentation</h5><p>Retinal hemorrhages are usually found in the setting of an acute infantile neurologic problem, such as seizure, lethargy, suspected or known head trauma. </p><h5>Pathology</h5><p>Retinal hemorrhages can appear to the ophthalmologist in various shapes depending on the layer(s) of the retina affected. They have been described as dot/blot, boat shaped, flame shaped, or splinter shaped.</p><h5>Radiographic features</h5><p>Retinal hemorrhages can be seen on MR SWI imaging <sup>2</sup>.</p><h5>Treatment and Prognosis</h5><p>Retinal hemorrhages usually resolve on their own within weeks of diagnosis. Severe hemorrhages can cause permanent visual loss.</p><h5>Practical Points</h5><p>Birth related hemorrhages are typically gone by age 1 month. After that, infantile retinal hemorrhages are commonly associated with abusive head trauma, however they can occur with other conditions that cause increased intracranial pressure or intracranial hemorrhage such as accidental trauma or asphyxiation, cerebral venous thrombosis, stroke, and encephalitis. </p>
References changed:
- 1. Callaway NF, Ludwig CA, Blumenkranz MS, Jones JM, Fredrick DR, Moshfeghi DM. Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-Year Results of the Newborn Eye Screen Test Study. (2016) Ophthalmology. <a href="https://doi.org/10.1016/j.ophtha.2016.01.004">doi:10.1016/j.ophtha.2016.01.004</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26875004">Pubmed</a> <span class="ref_v4"></span>
- 1. Callaway NF, Ludwig CA, Blumenkranz MS, Jones JM, Fredrick DR, Moshfeghi DM. Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-Year Results of the Newborn Eye Screen Test Study. (2016) Ophthalmology. <a href="https://doi.org/10.1016/j.ophtha.2016.01.004">doi:10.1016/j.ophtha.2016.01.004</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26875004">Pubmed</a> <span class="ref_v4"></span>
- 2. Zuccoli G, Panigrahy A, Haldipur A, Willaman D, Squires J, Wolford J, Sylvester C, Mitchell E, Lope LA, Nischal KK, Berger RP. Susceptibility weighted imaging depicts retinal hemorrhages in abusive head trauma. (2013) Neuroradiology. 55 (7): 889-93. <a href="https://doi.org/10.1007/s00234-013-1180-7">doi:10.1007/s00234-013-1180-7</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23568702">Pubmed</a> <span class="ref_v4"></span>
- 1. https://www.ncbi.nlm.nih.gov/pubmed/26875004
Image 1 MRI (SWI) ( create )
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