Prevalence of Retinal Hemorrhages in Infants After Extracorporeal Membrane Oxygenation

• Published in: American journal of ophthalmology Vol. 121; no. 3; pp. 297 - 303
• Main Authors: POLLACK, JOHN S., TYCHSEN, LAWRENCE
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-1996; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cerebral Hemorrhage - etiology; Emergency and intensive respiratory care; Extracorporeal Membrane Oxygenation - adverse effects; Female; Gestational Age; Humans; Infant; Infant, Newborn; Intensive care medicine; Male; Medical sciences; Missouri - epidemiology; Platelet Count; Prevalence; Retinal Hemorrhage - epidemiology; Retinal Hemorrhage - etiology; Risk Factors; Missouri; Human; Intensive care; Membrane oxygenator; Retinopathy; Prevalence; Cardiovascular disease; Respiratory intensive care; Infant; Retina; Hemorrhage; Vascular disease; Cardiopulmonary bypass; Eye disease; Newborn; Complication; Arteriovenous bypass
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(14)70278-8

To determine the prevalence of vision-threatening retinal hemorrhages in infants after venoarterial extracorporeal membrane oxygenation, and possible correlation between retinal hemorrhages and brain hemorrhages, thrombocytopenia, carotid reanastomosis, or death after extracorporeal membrane oxygenation.
We reviewed the findings of dilated ophthalmoscopic examinations performed on 37 children an average of 16 days after extracorporeal membrane oxygenation (35 neonates and two 1-year-old children).
Five (13%) of the 37 children examined had small (≤ 1 disk diameter) intraretinal hemorrhages. Presence or absence of retinal hemorrhages did not correlate with presence of cerebral hemorrhage, mean platelet count during extracorporeal membrane oxygenation, a history of reanastomosis of the carotid artery, or subsequent death.
Retinal hemorrhages observed after extracorporeal membrane oxygenation are not necessarily caused by extracorporeal membrane oxygenation; some hemorrhages may be benign and related to parturition. Children who undergo venoarterial extracorporeal membrane oxygenation are at low risk for vision-threatening retinal hemorrhage.