Choi Youn Joo, Jung Moon Sun, Kim So Young
Department of Ophthalmology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2011 Oct;25(5):311-6. doi: 10.3341/kjo.2011.25.5.311. Epub 2011 Sep 20.
To describe the ophthalmoscopic features and natural history in a case series of eyes that developed intraocular hemorrhages associated with perinatal distress and to evaluate their clinical courses.
A retrospective chart review of 289 neonates with a medical history of perinatal distress was conducted. Among these 289 patients (578 eyes), 29 eyes of 17 neonates were found to have had retinal hemorrhages or vitreous hemorrhages (VH). A comprehensive chart review, including details of fundoscopic findings and perinatal history, was conducted.
Intraocular hemorrhage was present in 5.5% of the patients. Most hemorrhages (82.7%) were intraretinal. In our population, 17% (n = 5) of hemorrhages resolved within two weeks, but 31% (n = 9) did not resolve even after four weeks. Most hemorrhages spontaneously resolved without any specific sequelae; however, one infant's dense unilateral VH persisted up to three months after birth. When the patient was seen again at 3.5 years of age, she had developed axial myopia and severe amblyopia of the involved eye.
In asphyxiated newborns, the possibility of intraocular hemorrhages should be considered. Long-standing, dense hemorrhages obscuring the macula may lead to severe vision deprivation amblyopia. Therefore, ophthalmic examination should be considered in neonates with perinatal distress, and close observation is necessary for hemorrhages that do not resolve in this amblyogenic age group.
描述一系列发生与围产期窘迫相关的眼内出血的眼睛的检眼镜特征和自然病程，并评估其临床经过。
对289例有围产期窘迫病史的新生儿进行回顾性病历审查。在这289例患者（578只眼）中，发现17例新生儿的29只眼有视网膜出血或玻璃体积血（VH）。进行了全面的病历审查，包括检眼镜检查结果和围产期病史的详细信息。
5.5%的患者存在眼内出血。大多数出血（82.7%）为视网膜内出血。在我们的研究人群中，17%（n = 5）的出血在两周内消退，但31%（n = 9）的出血即使在四周后仍未消退。大多数出血可自发消退，无任何特定后遗症；然而，一名婴儿的单侧密集VH在出生后持续了三个月。当该患者在3.5岁时再次就诊时，患眼出现了轴性近视和严重弱视。
对于窒息新生儿，应考虑眼内出血的可能性。长期存在的、遮挡黄斑的密集出血可能导致严重的剥夺性弱视。因此，对于有围产期窘迫的新生儿应考虑进行眼科检查，对于在这个易发生弱视的年龄组中未消退的出血，有必要密切观察。
