From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China.
Am J Ophthalmol. 2021 Jun;226:182-190. doi: 10.1016/j.ajo.2021.01.028. Epub 2021 Feb 5.
Neonatal retinal hemorrhage (NRH) is one of the most common neonatal fundus conditions. Hemorrhage resolves spontaneously; however, its long-term outcome is unknown yet. The current study explores the long-term role of NRH in foveal structure and visual function.
Cohort study (a prospective longitudinal study, in which the participants were followed up for 4-6 years).
A total of 125 healthy newborns during 2013-2015, including 50 newborns with NRH and 75 newborns without NRH, were enrolled. The eyes with NRH were further categorized into the foveal hemorrhage (FH) group and non-FH group. A comprehensive ophthalmic examination including best-corrected visual acuity (BCVA) measurement, slit-lamp examination, refractive error measurement, scanning laser ophthalmoscopy, and spectral-domain OCT was performed. Total retinal thickness (TRT) and the inner and outer retinal layers in the fovea were measured and compared.
The NRH was absorbed within 2.1 ± 0.98 weeks (median: 3 weeks). No difference was noted in the demographic characteristics between the groups; there was no significant difference in the logMAR BCVA (P = .83) or in the TRT. Subgroup analysis showed that TRT at the fovea in the FH group was significantly thicker (P = .005). Segmentation analysis showed a significantly thicker foveal outer nuclear layer (ONL) in the FH group (P = .017).
Birth-related retinal hemorrhage, even FH, might not lead to obvious visual abnormalities at the age of 4 years, at least according to this study with relatively small sample size. However, a thicker fovea, mainly attributed to a wider ONL and a shallower foveal pit, is noted in our study.
新生儿视网膜出血（NRH）是最常见的新生儿眼底疾病之一。出血会自行消退；然而，其长期后果尚不清楚。本研究探讨 NRH 对中心凹结构和视觉功能的长期影响。
队列研究（前瞻性纵向研究，参与者随访 4-6 年）。
纳入 2013-2015 年间的 125 名健康新生儿，包括 50 名 NRH 新生儿和 75 名无 NRH 新生儿。将 NRH 眼进一步分为中心凹出血（FH）组和非 FH 组。进行全面的眼科检查，包括最佳矫正视力（BCVA）测量、裂隙灯检查、屈光不正测量、扫描激光检眼镜和光谱域 OCT。测量并比较总视网膜厚度（TRT）和中心凹的内、外视网膜层。
NRH 在 2.1±0.98 周内（中位数：3 周）吸收。两组间的人口统计学特征无差异；logMAR BCVA（P=.83）或 TRT 无显著差异。亚组分析显示 FH 组中心凹处 TRT 明显较厚（P=.005）。分割分析显示 FH 组中心凹外核层（ONL）明显较厚（P=.017）。
出生相关的视网膜出血，即使是 FH，在 4 岁时也可能不会导致明显的视力异常，至少根据这项样本量相对较小的研究结果是如此。然而，我们的研究中注意到中心凹较厚，主要归因于 ONL 较宽和中心凹较浅。
