Retinal haemorrhage rates and resolution time of retinal haemorrhage in newborns after hypothermic treatment for hypoxic–ischemic encephalopathy - 23/11/19

Doi : 10.1016/j.arcped.2019.11.001

E. Eris ^a,⁎ , D. Eris ^b, Z. Seymen ^c, B. Karasu ^a, A. Dıracoglu ^d, I. Perente ^a, S. Cömert ^b
^a Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
^b Suleymaniye Education and Research Hospital Intensive Care Unit, Istanbul, Turkey
^c Suleymaniye Education and Research Hospital Ophthalmology clinic, Istanbul, Turkey
^d Haseki Education and Research Hospital Ophthalmology clinic, Istanbul, Turkey

^⁎Corresponding author.

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Abstract

Purpose

The aim of this study was to evaluate retinal hemorrhages (RHs) in newborns after therapeutic hypothermia performed for hypoxic–ischemic encephalopathy (HIE).

Methods

From 2014 January to October 2016, full-term newborns who were referred to us from the neonatal intensive care unit at our hospital for ophthalmological examination were evaluated retrospectively. Neonates diagnosed with HIE were examined with a RetCam Digital Retinal Camera (Massie Research Laboratories Inc., Pleasanton, CA) using a 130-degree or binocular indirect ophthalmoscope (Heine, Herrsching, Germany) imaging tool and were classified into three groups. Group 1 included patients without HIE, group 2 included patients with stage I HIE, and group 3 included patients with stage II or III HIE. The RH rates in cases of HIE were retrospectively reviewed.

Results

A total of 148 eyes of 74 patients were included in the study. RH was detected in 36 eyes (24.3%); there were two eyes (3.7%), 14 eyes (20.6%), and 20 eyes (76.9%), in groups 1, 2, and 3, respectively. In group 3, RH was mostly seen in a widespread form. RHs involving the macula were resorbed later than haemorrhages in other locations.

Conclusion

RHs are frequent in neonates with HIE. RHs were seen significantly more frequently in stage II–III HIE. These haemorrhages may require treatment, especially when the macula is involved.

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Keywords : Retinal hemorrhages, Hypoxic Ischemic Encephalopathy, HIE, Newborn, Sarnat Stages, Therapeutic Hypothermia