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Results for “RETINAL HEMORRHAGE”

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At least 451 records · Page 25Linked to original sources
PubMed2001

Diffuse unilateral hemorrhagic retinopathy associated with accidental perinatal strangulation. A clinicopathologic report.

OBJECTIVE: To report an unusual case of diffuse retinal hemorrhage associated with strangulation in a neonate with a tightly wrapped nuchal cord around his neck at birth who was noted to have eyelid and subconjunctival petechial hemorrhages upon delivery. METHODS: Clinical diagnostic examination as well as postmortem gross and histopathologic examination of ocular and central nervous system structures was performed. RESULTS: Funduscopic and gross pathologic examination of the eyes revealed extensive unilateral retinal hemorrhage of the right eye only. This was corroborated by histopathologic studies, which revealed unilateral diffuse hemorrhage throughout all nuclear layers of the retina with a particularly dense nerve fiber layer and sub-internal limiting membrane hemorrhage in the macula along with extraocular muscle and episcleral hemorrhage. Clinical, gross, and microscopic examination also revealed multiple areas of hemorrhage involving the right side of the brain and throughout the cerebellum. CONCLUSION: Although retinal findings in nonaccidental trauma are common, accidental strangulation retinopathy in neonates is a rare occurrence. To the authors' knowledge, this case is the only documented histopathologic study of hemorrhagic retinopathy associated with strangulation in the literature.

Airway Obstruction↗
PubMed2005

Macular hole and sub-hyaloid hemorrhage following filtering surgery with mitomycin C.

BACKGROUND: We report the occurrence of a macular hole with sub-hyaloid hemorrhage following filtering surgery with mitomycin C. METHODS: Combined trabeculotomy and trabeculectomy with mitomycin C was performed in the left eye for primary congenital glaucoma. RESULTS: Two weeks postoperatively the fundus showed a macular hole with subretinal and retinal hemorrhage along with sub-hyaloid bleeding. Optical coherence tomography confirmed the presence of a full-thickness macular hole. CONCLUSION: A full-thickness macular hole with subretinal and retinal hemorrhage is reported as a complication of glaucoma filtering surgery.

Child↗
PubMed1991

A randomized comparison of assisted vaginal delivery by obstetric forceps and polyethylene vacuum cup.

The assisted vaginal delivery methods of rigid obstetric forceps and polyethylene vacuum cup extraction were compared in a prospective, randomized study. The 99 women studied had all completed 35 full weeks' gestation, required attempted assisted vaginal delivery, and were randomly assigned to either attempted forceps or vacuum-assisted delivery. All presentations were cephalic, with stations ranging from +1 to +4. Neonates were evaluated at 24 hours by neonatal staff. The infants underwent intracranial ultrasound screening during the first 24 hours of life and ophthalmologic examination within 48 hours. Vaginal delivery was successful with the intended method in 83% of vacuum-assisted deliveries and in 78% of forceps deliveries (not statistically significant). Neonatal retinal hemorrhage was found in 17 and 38% (P less than .043) of the randomized forceps and vacuum deliveries, respectively. No intraventricular hemorrhage was found. Apart from associations between vacuum-assisted delivery and mild hyperbilirubinemia and neonatal retinal hemorrhage (of uncertain clinical significance), and between assisted forceps delivery and an increased potential for facial injury, neonatal outcomes did not differ significantly. Maternal outcomes also did not differ significantly. No significant differences in safety or efficacy were found between polyethylene cup vacuum extraction and rigid obstetric forceps-assisted vaginal delivery in this population of predominantly low-pelvic assisted deliveries. Patients delivered by sequential use of forceps after vacuum or by vacuum after failed forceps application did not suffer significantly increased morbidity relative to those delivered by forceps or vacuum alone. Use of alternate or sequential methods allowed an overall cesarean rate of 3% in this population.

Acid-Base Equilibrium↗
PubMedDate not supplied

Hemorrhagic retinopathy in newborns: frequency, form of presentation, associated factors and significance.

During the first 72 hours of their lives, 420 neonates were checked for retinal hemorrhages and macular affection. The neonate's gestational age, birth weight, and Apgar scores and maternal data (nulliparty, fetal presentation, duration of labor and delivery, induction of labor and obstetric technique) were all recorded. In 81 cases (19.2%), retinal hemorrhages were found. No significant relation was established with any of the associated factors, except for a significantly lower frequency of hemorrhages in cases of cesarean delivery (p < 0.01) and a significantly longer expulsive phase in the group with hemorrhages (p < 0.05). In follow-up examination 3 to 4 months later, neither the infants with hemorrhages nor the control group presented alterations.

Cesarean Section↗
PubMed1989

Bilateral central retinal vein occlusion in Waldenström's macroglobulinemia.

Waldenström's macroglobulinemia is a rare progressive neoplastic plasma cell disorder. Hyperviscosity is a major component in primary macroglobulinemia due to the excessive production of IgM paraprotein, a tumor by-product. The ocular manifestations of hyperviscosity can include congestion of the conjunctival vessels, dilation, segmentation and tortuosity of retinal vessels, retinal hemorrhages and serous retinal detachment. This case of bilateral central retinal vein occlusion represents an uncommon complication of Waldenström's macroglobulinemia.

Fundus Oculi↗
PubMed1975

Purtscher retinopathy in the battered child syndrome.

Purtscher retinopathy is a hemorrhagic angiopathy that occurs after sudden compression of the thorax. Virtually all reported cases have been in adults who have decreased visual acuity, retinal hemorrhages and exudates, and no other neurological signs. By contrast, in infants, hemorrhagic retinopathy is rarely benign, and generally is considered to indicate intracranial hemorrhage, usually an acute subdural hematoma. Two battered infants had seizures and associated chest injury. There were retinal hemorrhages and exudates, unaccompanied by clinically important intracranial hemorrhage. At follow-up, the hemorrhagic retinopathy had resolved without sequelae; development was normal, and seizures had not recurred. Purtscher retinopathy thus should be added both to the differential diagnosis of hemorrhagic retinopathy in infancy and to the list of physical signs suggesting child abuse.

Battered Child Syndrome↗
PubMed1981

Papilledema with unusual ocular hemorrhages.

Fourteen patients with posterior pole retinal hemorrhages or prominent subhyaloid and vitreous bleeding were found during examination of 402 consecutive patients with papilledema (4%). Subhyaloid and vitreous hemorrhage generally result from forward dissection of severe peripapillary hemorrhage, whereas scattered posterior pole hemorrhages probably represent central retinal vein compromise from optic disc swelling. The bilaterality and severity of papilledema, as well as the clinical course, distinguish these patients from those with venous hemorrhages in association with subarachnoid bleeding or primary central retinal vein occlusion or inflammation.

Adult↗
PubMed1997

Evidence for breaches of the retinal vasculature in acquired immune deficiency syndrome angiopathy. A fluorescent microsphere study.

PURPOSE: The author studied the retinal vasculature in patients with acquired immune deficiency syndrome (AIDS) by infusion of microspheres impregnated with fluorescent dye. METHODS: Experimental study of the structural integrity of the retinal microvasculature in 14 autopsy patients with AIDS was compared with age- and gender-matched control retinas. MATERIALS: Fourteen autopsy eyes from patients with AIDS, eight autopsy eyes from immunosuppressed control patients, and four autopsy eyes from nonimmunosuppressed control patients were studied. EXPERIMENTAL METHOD: The central retinal arteries of autopsy eyes were perfused with fluorescent microspheres of 10 and 200 nm in diameter. The retinas were dissected from the eyes and viewed by fluorescence microscopy. RESULTS: Vascular breaches permeable to 200-nm microspheres were discovered in eyes from patients with AIDS. Ruptured microaneurysms were identified at the center of retinal hemorrhages in 7 of 14 eyes from patients with AIDS and 5 of 8 immunosuppressed control eyes. Leakage around microaneurysms occurred even in the absence of hemorrhage and were more frequent in eyes from patients with AIDS (11/14) than in control eyes (3/12). Cotton wool patches were surrounded by tortuous retinal vessels and microaneurysms. CONCLUSIONS: Ruptured microaneurysms are a frequent cause of retinal hemorrhage in immunosuppressed patients. Breaches in microaneurysms occur even in the absence of hemorrhage. These breaches are often at least 200 nm in diameter, a size that is permissive to capsids and virions of cytomegalovirus (CMV). Ruptured and/or leaky microaneurysms are potential sources of CMV permeation of the blood-retinal barrier. Breaches of the retinal microvasculature are not specific to patients with AIDS and occur frequently in other immunosuppressed patients.

AIDS-Related Opportunistic Infections↗
PubMed2006

Vitreoretinal complications of retinoblastoma treatment.

PURPOSE: To describe complications of the retina and vitreous occurring in children undergoing treatment for retinoblastoma and their clinical management. METHODS: Retrospective analysis of Ret-Cam images of 206 patients with retinoblastoma treated at one center between 1996 and 2003. Images were studied for vitreoretinal features other than tumor persistence or recurrence. Specifically, complications such as vitreous, retinal, or choroidal hemorrhage, retinal detachment, retinal fold, vascular obstruction, and preretinal or subretinal proliferation were sought. RESULTS: Vitreoretinal complications of retinoblastoma therapy were identified in 14 patients (6.8%) All had heritable bilateral retinoblastoma. Group 5 Reese-Ellsworth disease was present in 50% (n = 7). All patients had systemic chemotherapy, 50% had external beam radiotherapy, and 64% had more than one local treatment method. Of the 14 patients with a complication, 4 eyes were enucleated for massive recurrence of tumor, 5 eyes were observed, and 5 eyes were treated successfully with vitreoretinal surgery for tractional or rhegmatogenous retinal detachment. CONCLUSION: Vitreoretinal complications occurred in 6.8% of patients undergoing therapy for retinoblastoma. These included retinal tears, rhegmatogenous and tractional retinal detachment, subretinal fibrosis, vitreous traction bands, preretinal fibrosis, and pseudo-vitreous seeding. They were more often seen when systemic chemotherapy was combined with external beam radiation, cryotherapy, and local chemotherapy.

Antineoplastic Agents↗
PubMed1993

Ocular and associated neuropathologic observations in suspected whiplash shaken infant syndrome. A retrospective study of 12 cases.

We examined the eyes of 12 infants who died with the clinical and pathologic diagnosis of the shaken baby syndrome. The ocular histopathologic findings and the neuropathologic findings were compared. Preretinal, intraretinal, and subretinal hemorrhages were observed; hemorrhages of the superficial retinal layers and subsensory retinal space predominated. Retinal hemorrhages were found in 12 cases, intracranial hemorrhage was found in 11 cases, and cerebral edema was found in 10 cases. The intraretinal and periretinal hemorrhages were most prevalent at the posterior pole. Five cases had retinal folds. There was a low incidence of optic disc edema and choroidal hemorrhage.

Brain Edema↗
PubMed2005

Ocular complications of Rift Valley fever outbreak in Saudi Arabia.

OBJECTIVE: To report ocular complications of Rift Valley fever (RVF) during its first reported outbreak in southwest Saudi Arabia in autumn 2000. DESIGN: Cross-sectional study of patients in a referral hospital. PARTICIPANTS: One hundred forty-three consecutive patients with confirmed RVF serologic test results and ocular lesions were enrolled in the study. METHODS: Hospitalized patients (n = 30) and outpatients (n = 113) with clinical symptoms consistent with RVF, positive RVF serologic test results, and ocular abnormalities were studied. Ophthalmologic examinations, including fundus photography and fluorescein angiography, were performed. Patients were followed up at regular intervals to determine the prognosis and outcome of identified ocular abnormalities. MAIN OUTCOME MEASURES: Visual acuity at initial presentation and course of anterior and posterior segment complications. RESULTS: Among 143 patients (78% males; mean age, 53.2 years), 212 eyes were affected, comprising 47 eyes in 30 inpatients and 165 eyes in 113 outpatients. The mean interval between the onset of RVF and visual symptoms ranged from 4 to 15 days (mean, 8.8 days). Macular or paramacular retinitis was identified in all the affected eyes (n = 212) at the time of initial assessment. Lesions included retinal hemorrhages (40%), vitreous reactions (26%), optic disc edema (15%), and retinal vasculitis (7%). Anterior uveitis was present in 31% of outpatients. Fluorescein angiography of the retinitis showed early hypofluorescence with late staining of retinal lesions and blood vessels. Initial visual acuity was less than 20/200 in 80% of eyes in the outpatient group; their vision improved, deteriorated, or remained the same in 13%, 15%, or 72%, respectively. Evaluation at the last follow-up showed macular (60%) or paramacular (9%) scarring, vascular occlusion (23%), and optic atrophy (20%) in the outpatient group. CONCLUSIONS: Rift Valley fever was associated with major ocular morbidity. Ocular manifestations of RVF occurred with a relatively higher frequency than reported up to now and were not limited to severe infections. Rift Valley fever affects the uvea and posterior chorioretinal area and is associated with permanent visual loss resulting from macular and paramacular scarring, vascular occlusion, and optic atrophy. The study demonstrated for the first time that transient nongranulomatous anterior uveitis is associated with RVF.

Adolescent↗
PubMed1992

Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age.

Head injury in the youngest age group is distinct from that occurring in older children or adults because of differences in mechanisms, injury thresholds, and the frequency with which the question of child abuse is encountered. To analyze some of these characteristics in very young children, the authors prospectively studied 100 consecutively admitted head-injured patients 24 months of age or younger who were drawn from three institutions. Mechanism of injury, injury type, and associated injuries were recorded. All patients underwent ophthalmologic examination to document the presence of retinal hemorrhages. An algorithm incorporating injury type, best history, and associated findings was used to classify each injury as inflicted or accidental. The results confirmed that most head injuries in children younger than 2 years of age occurred from falls, and while different fall heights were associated with different injury types, most household falls were neurologically benign. Using strict criteria, 24% of injuries were presumed inflicted, and an additional 32% were suspicious for abuse, neglect, or social or family problems. Intradural hemorrhage was much more likely to occur from motor vehicle accidents and inflicted injury than from any other mechanism, with the latter being the most common cause of mortality. Retinal hemorrhages were seen in serious accidental head injury but were most commonly encountered in inflicted injury. The presence of more serious injuries associated with particular mechanisms may be related to a predominance of rotational rather than translational forces acting on the head.

Accidental Falls↗
PubMed1996

Indocyanine green angiographic features of pathologic myopia.

PURPOSE: To analyze indocyanine green angiographic findings of pathologic myopia and compare them with those of fluorescein angiography, with particular reference to the usefulness of indocyanine green angiography in the management of neovascular complications. METHODS: Thirty-two consecutive patients (52 eyes) with pathologic myopia underwent a complete ophthalmologic examination including fluorescein and indocyanine green angiography. RESULTS: Retrobulbar arteries and veins were visualized solely on indocyanine green angiography in 33 (63%) of 52 eyes. Choroidal arteries appeared attenuated and reduced in number. In the area of staphyloma, choroidal veins were less numerous, and in all eyes an absence of the normal choroidal flush caused by the choriocapillaris filling was observed. Subretinal and retinal hemorrhages were present in 28 (54%) of 52 eyes. Choroidal neovascularization was diagnosed in 16 eyes on fluorescein angiography and in 18 eyes on indocyanine green angiography. In seven eyes, indocyanine green angiography disclosed lacquer cracks (without choroidal neovascularization), appearing in the late phases as hypofluorescent lines, as the probable cause of the subretinal and retinal hemorrhages. In only one eye did indocyanine green angiography fail to disclose choroidal neovascularization detectable on fluorescein angiography. In two eyes, neither dye could clarify the origin of the hemorrhages. CONCLUSIONS: Indocyanine green angiography allows identification of retrobulbar arteries and veins, and analysis of the altered choroidal vasculature. Moreover, indocyanine green angiography is a useful diagnostic tool to differentiate lacquer cracks from choroidal neovascularization in retinal and subretinal hemorrhages.

Adolescent↗
PubMed1997

Visual system degeneration induced by blast overpressure.

The effect of blast overpressure on visual system pathology was studied in 14 male Sprague-Dawley rats weighing 360-432 g. Blast overpressure was simulated using a compressed-air driven shock tube, with the aim of studying a range of overpressures causing sublethal injury. Neither control (unexposed) rats nor rats exposed to 83 kiloPascals (kPa) overpressure showed evidence of visual system pathology. Neurological injury to brain visual pathways was observed in male rats surviving blast overpressure exposures of 104-110 kPa and 129-173 kPa. Optic nerve fiber degeneration was ipsilateral to the blast pressure wave. The optic chiasm contained small numbers of degenerated fibers. Optic tract fiber degeneration was present bilaterally, but was predominantly ipsilateral. Optic tract fiber degeneration was followed to nuclear groups at the level of the midbrain, midbrain-diencephalic junction, and the thalamus where degenerated fibers arborized among the neurons of: (i) the superior colliculus, (ii) pretectal region, and (iii) the lateral geniculate body. The superior colliculus contained fiber degeneration localized principally to two superficial layers (i) the stratum opticum (layer III) and (ii) stratum cinereum (layer II). The pretectal area contained degenerated fibers which were widespread in (i) the nucleus of the optic tract, (ii) olivary pretectal nucleus, (iii) anterior pretectal nucleus, and (iv) the posterior pretectal nucleus. Degenerated fibers in the lateral geniculate body were not universally distributed. They appeared to arborize among neurons of the dorsal and ventral nuclei: the ventral lateral geniculate nucleus (parvocellular and magnocellular parts); and the dorsal lateral geniculate nucleus. The axonopathy observed in the central visual pathways and nuclei of the rat brain are consistent with the presence of blast overpressure induced injury to the retina. The orbital cavities of the human skull contain frontally-directed eyeballs for binocular vision. Humans looking directly into an oncoming blast wave place both eyes at risk. With bilateral visual system injury, neurological deficits may include loss or impairments of ocular movements, and of the pupillary and accommodation reflexes, retinal hemorrhages, scotomas, and general blindness. These findings suggest that the retina should be investigated for the presence of traumatic or ischemic cellular injury, hemorrhages, scotomas, and retinal detachment.

Air Pressure↗
PubMed2006

Risk factors for retinopathy associated with interferon alpha-2b and ribavirin combination therapy in patients with chronic hepatitis C.

AIM: To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy. METHODS: We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy. RESULTS: Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%) despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension, or pretreatment arteriosclerotic changes in the optic fundi. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P = 0.004, OR = 245.918, 95% CI = 5.6-10786.2). CONCLUSION: Retinopathy associated with combination therapy of interferon alpha-2b and ribavirin tends to develop in patients with hypertension.

Adult↗
PubMed1981

Treatment of macular subretinal neovascularization with the red-light krypton laser in presumed ocular histoplasmosis syndrome.

A patient with presumed ocular histoplasmosis and decreased visual acuity in one eye had subretinal neovascularization and retinal hemorrhage in the macular area. Argon-laser treatment to eradicate the subretinal neovascular membrane was contraindicated because of the proximity of the hemorrhagic lesion to the fovea. We used a red-light krypton laser (647 nm) because the light is not absorbed by the hemoglobin in the retinal hemorrhage or by the macular luteal pigment (xanthophyll), and because it is transmitted into the choroid, allowing treatment within the macular zone with less damage to the internal retinal elements. After treatment, the subretinal neovascular membrane completely disappeared and the macular hemorrhage cleared. To the best of our knowledge, this is the first time that a histoplasmic macular subretinal neovascular membrane has been treated with the red-light krypton laser.

Eye Diseases↗