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At least 325 records · Page 18Linked to original sources
PubMed1993

[Expulsive retinal hemorrhage. Secondary treatment by vitreoretinal surgery].

Expulsive hemorrhage is a catastrophic complication of intraocular surgery that can result in total loss of vision. Patients with massive hemorrhagic choroidal detachment were treated by vitrectomy and silicone oil or gas tamponade. A reattachment of the retina was achieved with stabilization of visual function. Properly timed drainage of the choroidal fluid components with pars plana vitrectomy and silicone or gas injection is a useful approach in these disorders and may salvage useful vision in complicated cases.

Adult↗
PubMed2001

[Traumatic vitreous-retinal hemorrhage in infants].

After a short review of the non-traumatic, and rare, causes of vitreoretinal hemorrhages in infants, we analyze the 4 situations where a traumatic hemorrhage can be found: accidental head trauma, which has to be very severe and is then an unfrequent etiology, head trauma in child abuse or the so-called "shaken baby syndrome", which is the most frequent cause, and where we point out the key role of the ophthalmologist in the diagnosis and the prognostic evaluation, the perinatal trauma, which is a frequent, benign, and ephemeral cause, and finally, cardiopulmonary resuscitation, which is a controversial and unlikely cause.

Birth Injuries↗
PubMed1997

[Retinal hemorrhage in the infant as an indication of shaken baby trauma].

BACKGROUND: The shaken baby syndrome is a form of child abuse in young children. Typical are intracranial and intraocular bleedings. As external injuries are often missing, the shaken baby syndrome may easily be overlooked. Intraocular bleeding is a major diagnostic sign and can prove the diagnosis, if child abuse is suspected by the paediatrician. Thus critical family situations can be uncovered and long term help can be initiated. PATIENTS: Between 1991 and 1997 seven babies (age two to nine months) with intraocular bleedings were examined. Diagnosis, differential diagnosis and prognosis of the shaken baby syndrome are presented with these children. RESULTS: In two of the seven children a non-accidental trauma and shaken baby syndrome was obvious. In three cases the diagnosis of a shaken baby syndrome was most probable. In one child intraocular bleeding was possibly caused by a fall three months earlier. One child had retinal bleedings after resuscitation. In two cases a vitrectomy was performed. The follow up was two months to six years. In two children intraocular bleeding resolved completely, three children developed mild to severe amblyopia and two children became blind. Vitrectomy could not prevent loss of sight. CONCLUSIONS: Sudden cerebral symptoms or intraocular bleedings in otherwise healthy young children are suspicious for child abuse. A shaken baby syndrome has to be considered. Thus funduscopic examination in mydriasis is obligatory. The prognosis depends on the severeness of ocular hemorrhages and cerebral lesions.

Battered Child Syndrome↗
PubMed1991

Neonatal macular hemorrhage.

Retinal hemorrhages occur with increased frequency in neonates following prolonged or difficult labor, especially if associated with primipara, surgical or mechanical intervention, low Apgar scores, perinatal hypoxia, low birth weight or coagulopathy. When involvement occurs peripheral to the arcades resolution occurs generally without sequelae. Hemorrhages involving the macula are much more serious since resolution in these cases may result in degenerative changes or an exudative or glial scar, resulting in amblyopia and possible strabismus. Early examination is warranted in high-risk infants in order to facilitate intervention and the prevention of more serious visual sequelae.

Adult↗
PubMedDate not supplied

Ocular complications in myelodysplastic syndromes as preleukemic disorders.

PURPOSE: To identify ocular complications in patients with myelodysplastic syndromes (MDS), who have a propensity to progress to acute myeloid leukemia (AML). METHODS: Forty-one patients with MDS were the subjects in this retrospective study, and 21 patients with AML were selected as controls. Reviewing their clinical records, we verified that corneal ulcer, iridocyclitis, vitreous hemorrhage, retinal hemorrhage, and optic neuritis had been evaluated using slit-lamp assessment and opthalmoscopy in all the patients. In this study, the MDS patients were classified into those with refractory anemia (RA) and those with refractory anemia with excess blasts (RAEB). RESULTS: Ocular complications were found in 19 (46.3%) of the 41 patients with MDS, comprising corneal ulcer (two cases), iridocyclitis (five), vitreous hemorrhage (one), retinal hemorrhage (ten), cotton wool spots (one), and optic neuritis (two). (Some patients had more than one ocular complication.) Ocular complications were identified in 12 of the 21 (57.1%) patients with AML. There was no significant difference in frequency of ocular complications between MDS and AML (P = 0.4892). In MDS, retinal hemorrhage was associated with significantly reduced platelet counts (P = 0.0063). The frequency of ocular complications was significantly higher in MDS-RAEB than in MDS-RA (P = 0.0478). Retinal hemorrhage was significantly more frequent in patients with MDS-RAEB than in patients with MDS-RA (P = 0.0433). CONCLUSION: Ocular complications in MDS patients should be carefully examined as prognostic factors for progression to acute leukemia.

Acute Disease↗
PubMedDate not supplied

Inflicted childhood neurotrauma (shaken baby syndrome): ophthalmic findings.

Inflicted childhood neurotrauma (shaken baby syndrome) is the term used for violent, nonaccidental, repetitive, unrestrained acceleration-deceleration head and neck movements, with or without blunt head trauma, combined with a unique, age-related biomechanical sensitivity in children typically younger than 3 years. This syndrome is typically characterized by a combination of fractures, intracranial hemorrhages, and intraocular hemorrhages. Retinal hemorrhage is the most common ophthalmic finding, and usually occurs at all levels of the retina. In recent years, increasing pressure has been placed on ophthalmologists to render diagnostic interpretations of the retinal findings in children suspected to be victims, which may have great forensic implications in criminal proceedings. New research has increased our understanding of the pathophysiology of retinal hemorrhages, the importance of specifically characterizing the types, patterns, and extent of these retinal hemorrhages, and the differential diagnosis.

Child, Preschool↗
PubMed1992

Complications of glaucoma surgery. Ocular decompression retinopathy.

In seven eyes of four patients, retinal hemorrhages were observed following trabeculectomy under both local and general anesthesia. The hemorrhages were diffuse, both deep and superficial, and many had white centers when first observed. Two patients were young healthy male myopes undergoing primary trabeculectomy. The third patient was a young man with chronic uveitis. The fourth patient was an elderly man with primary open angle glaucoma who had an acute rise in intraocular pressure following cataract extraction. Intraocular pressure and visual results appeared unaffected by the hemorrhages. Retinal hemorrhages associated with ocular decompression appear to be relatively benign.

Adolescent↗
PubMed1989

[The ocular fundus findings in dengue fever].

From September to December of 1988, 24 cases of clinical diagnosed dengue fever accompanied by visual disturbances were studied. A detailed history and a detailed ocular examination including visual acuity, slit lamp examination, fundus examination through dilated pupil and fluorescein angiography were conducted. In some cases, Amsler grid, visual field, visual evoked potential and color vision test were also evaluated. The chief complaints of these 24 patients were blurred vision, central scotoma, floaters, photophobia and halo vision. The intervals between onset of fever and awareness of blurred vision were 2 to 15 days with an average of 7.26 days. The ocular fundus changes included macular hemorrhage, retinal hemorrhage, maculopathy, Roth's spot, diffuse retinal edema, peripapillary hemorrhage vitreous cells and blurring optic disc. The fluorescein angiographic findings included poor choroidal flushing, delayed disc filling, disc extravasation, block fluorescence, capillary obliteration, non filling of macular network, capillary leakage and window defect. Seventeen cases (30 eyes) were followed-up for 2 weeks to 3 months. Visual recovery was good in most of the cases. However, 2 cases (4 eyes) showed poor visual outcome. In this series studied, the principle ocular fundus change caused by dengue fever was macular hemorrhage. This may be due to the capillary changes near the macular area. But in some of the cases, the direct viral invasion and/or indirect changes of the optic nerve, the retinal pigment epithelium or photoreceptors should be considered.

Adolescent↗
PubMed1997

Screening for ocular hemorrhages in patients with ruptured cerebral aneurysms: a prospective study of 99 patients.

BACKGROUND: Terson's syndrome (vitreous hemorrhage) and other ocular hemorrhages (retinal hemorrhages) have been reported to occur in up to 40% of patients with ruptured cerebral aneurysms. Because microsurgical vitrectomy can safely restore vision in patients with visual loss secondary to Terson's syndrome, we hypothesized that prospectively screening a selected group of patients with aneurysms would result in a higher rate of vitrectomy in patients with more extensive subarachnoid hemorrhage. METHODS: Ninety-nine patients with ruptured cerebral aneurysms were prospectively screened for Terson's syndrome and other forms of ocular hemorrhage by an ophthalmologist. Follow-up data were obtained for seven of eight cases of Terson's syndrome, and vitrectomy was performed for visual restoration when indicated. RESULTS: Ocular hemorrhages were present in 17% of patients with ruptured cerebral aneurysms, and Terson's syndrome was present in 8% of patients. Screening of patients with histories of transient or prolonged comas sensitively identified patients with ocular hemorrhages in 100% of the patients with Terson's syndrome and 89% of the patients with other ocular hemorrhages. Fifty-five percent of the patients in the overall series had histories of transient or prolonged comas, and 53% (specificity) of those patients had ocular hemorrhages. Two of the eight patients with Terson's syndrome underwent vitrectomy, with dramatic improvement in vision. No other ocular hemorrhages required surgery. CONCLUSIONS: Ophthalmological screening of patients with histories of transient or prolonged comas after ruptured cerebral aneurysms very sensitively identifies patients with ocular hemorrhages, which are relatively common in patients with subarachnoid hemorrhage treated in an academic neurosurgical practice. The present study underestimates the true incidence of Terson's syndrome in that patients who died shortly after their subarachnoid hemorrhage were not included. Vitrectomy for patients who do not exhibit spontaneous improvement in vision results in a dramatic reversal of blindness.

Adult↗
PubMed1999

Shaken baby syndrome and the death of Matthew Eappen: a forensic pathologist's response.

Subdural hemorrhage, retinal hemorrhage, and cerebral edema have been considered diagnostic for a "shaken infant" since the syndrome was described almost 30 years ago. However, the specificity of these findings has been disputed by defense witnesses in recent U.S. criminal prosecutions. This review examines the scientific basis for the shaken baby syndrome.

Battered Child Syndrome↗