Frontiers in Pediatrics (Sep 2022)

Analysis of non-retinopathy of prematurity (ROP)–related fundus hemorrhage in preterm infants in China

  • Sun Yaoyao,
  • Sun Yaoyao,
  • Sun Yaoyao,
  • Sun Yaoyao,
  • Deng Kaixin,
  • Deng Kaixin,
  • Deng Kaixin,
  • Deng Kaixin,
  • Deng Kaixin,
  • Li Xiaoxin,
  • Li Xiaoxin,
  • Li Xiaoxin,
  • Li Xiaoxin,
  • Zhao Min,
  • Zhao Min,
  • Zhao Min,
  • Zhao Min,
  • Jiang Yanrong,
  • Jiang Yanrong,
  • Jiang Yanrong,
  • Jiang Yanrong,
  • Yin Hong,
  • Yin Hong,
  • Yin Hong,
  • Yin Hong,
  • Qi Huijun,
  • Qi Huijun,
  • Qi Huijun,
  • Qi Huijun,
  • Qian Tong,
  • Qian Tong,
  • Qian Tong,
  • Qian Tong,
  • Linghu Dandan,
  • Linghu Dandan,
  • Linghu Dandan,
  • Linghu Dandan,
  • Yu Wenzhen,
  • Yu Wenzhen,
  • Yu Wenzhen,
  • Yu Wenzhen,
  • Zhao Mingwei,
  • Zhao Mingwei,
  • Zhao Mingwei,
  • Zhao Mingwei,
  • Liang Jianhong,
  • Liang Jianhong,
  • Liang Jianhong,
  • Liang Jianhong

DOI
https://doi.org/10.3389/fped.2022.985268
Journal volume & issue
Vol. 10

Abstract

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ObjectiveTo determine the incidence of fundus hemorrhage (FH) not associated with retinopathy of prematurity (ROP) during ocular screening and report their clinical features, risk factors, therapies, and prognosis in a large population of premature newborns.MethodsThe medical records of all preterm newborns admitted to the Department of Ophthalmology, Peking University People's Hospital, Beijing, from January 1, 2016 through August 31, 2021 were retrospectively reviewed. Fundus examinations were carried out by experienced retinal experts. Examination under anesthesia was carried out in newborns with abnormal fundus including vitreous hemorrhage (VH) or retinal hemorrhage (RH) >2 disks' diameter by a Retcam 2 system. A lens-preserving vitrectomy was performed in infants requiring a vitrectomy. A comprehensive medical history was also recorded and analyzed.ResultsDuring the 5-year period, a total of 7,260 preterm babies were screened. There were 82 (1.13%) newborns and 104 (0.72) eyes with FH, including VH or RH.Twelve (14.63%) newborns (16 eyes, 15.38%) had VH; 56 (68.29%) (74 eyes, 71.15%) had flame-shaped, superficial hemorrhages; six (7.31%) (6 eyes, 5.77%) had small, round, deep hemorrhages (<2 disk diameters in size); and eight (9.76%) (8 eyes, 7.69%) had large, round hemorrhages (>2 disk diameters). In all, there were 10 (12.20%) cases of intracranial hemorrhage. The mode of delivery was not found to be a significant factor in the occurrence of birth-related retinal hemorrhage (P = 0.22).Six newborns (eyes) with large, round retinal hemorrhage at the posterior pole while the macular was not impacted and 11 cases (15 eyes) with vitreous hemorrhage were required to receive close follow-up with average follow-up time of 105 days. A lens-sparing vitreous surgery was conducted in three patients without any complications.ConclusionPreterm newborns with FH that are not caused by ROP are more likely to have superficial, peripheral hemorrhages. Vaginal delivery compression and forceps may be associated with hemorrhage. A lens-preserving vitrectomy is required and considered safe for dense FH involving the refractive media.

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