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PubMed1988

Retinal hemorrhages and traction forces in vacuum extraction.

The relationship between the traction forces used in 53 clinically indicated vacuum extractions and the incidence and degree of retinal hemorrhages observed in the neonates within 24 hours after birth was examined. A Vacuum Extractor Recorder (Type SF 30, Knick), was used to measure the traction force necessary for delivery of the fetal head. No relationship could be demonstrated between the force time integral and the appearance and grading of retinal bleedings.

Adult↗
PubMed1981

[Altitude-induced retinal hemorrhages. A new aspect of mountain sickness].

The authors discuss modern views on altitude acclimatization and acute mountain sickness (A.M.S.). They particularly consider recent observations of high altitude retinal hemorrhages (H.A.R.H.). They report some subjects they personally examined and suggest the probable factors involved in the pathogenesis of the disorder.

Acute Disease↗
PubMed2002

Retinal hemorrhage after photodynamic therapy in patients with subfoveal choroidal neovascularization caused by age-related macular degeneration.

PURPOSE: To report the frequency and the evolution of the extensive retinal hemorrhages that can appear within 48 h after the application of photodynamic therapy. METHODS: Two hundred and fifteen individual eyes of 194 consecutive patients with subfoveal choroidal neovascularization (CNV) due to age-related macular degeneration who underwent photodynamic treatment were included in the study. The visual acuity was measured before and after treatment. Color and red-free photographs were taken. Fluorescein angiography and optical coherence tomography (OCT) were also performed in order to describe the macular hemorrhages. RESULTS: Four out of 215 eyes developed macular hemorrhage within 48 h after the photodynamic therapy. Before treatment one of the four patients had classic CNV, one predominantly classic and two patients occult CNV without any classic component. In all four cases, the hemorrhage after photodynamic therapy (PDT) was extensive, it extended beyond the arcades and it was not absorbed during the follow-up period, which ranged from 11 to 21 months. The greatest linear dimension of the hemorrhage was extremely high (>12,000 microm). CONCLUSION: Extensive macular hemorrhage was observed in 1.86% of the studied cases. The hemorrhage was not related to the type of the CNV lesion before treatment. The size and the appearance of hemorrhage within 48 h after treatment support the view that the hemorrhage is a direct consequence of the photodynamic therapy and not related to the natural course of the disease.

Aged↗
PubMed1985

Retinal hemorrhages in the newborn following labor induced by oxytocin or dinoprostone.

We examined the fundi of 100 newborns following labor induced by intravenous oxytocin or by oral dinoprostone. Retinal hemorrhage was observed in 40% of neonates in the dinoprostone treatment group, as compared with 28% in the oxytocin treatment group. The accumulation of prostaglandins in the fetal circulation may be responsible for the hemorrhages, which clear spontaneously once the noxious agent is metabolized. Other organ systems must be carefully examined in the neonate to detect other possible untoward effects.

Dinoprostone↗
PubMed1978

[High altitude retinal hemorrhages in mountain climbers (author's transl)].

A report is given on three patients who noticed an acute deterioration of visual acuity after a sojourn at 5000 altitude caused by retinal hemorrhages. We documented both the ophthalmological examinations such as visual acuity, fundus, perimetry and fluorescence-angiography and the systemic results. During the period of about half a year after the incidence of deterioration of visual acuity we followed the course of illness. The pathophysiological mechanism, and therapeutical and prophylactical possibilities are discussed in consideration of the results of other authors.

Adult↗
PubMed1987

White centered retinal hemorrhages in diabetic retinopathy.

Two hundred fifteen diabetic patients (430 eyes) with early proliferative retinopathy, moderate-to-severe nonproliferative retinopathy, and/or diabetic macular edema in each eye were examined for the presence of white centered retinal hemorrhages (WCRHs). Of the eyes examined, 15.6% demonstrated at least one WCRH and 4.9% showed five or more WCRHs. The prevalence of WCRHs was not significantly related to hypertension, anemia, leukocytosis, thrombocytopenia, thrombocytosis, abnormalities of coagulation, increased serum creatinine, or ingestion of oral contraceptives. Local factors associated with microvascular damage and repair are likely responsible for WCRHs in diabetics. Microaneurysms are at the center of many diabetic WCRHs, and the pale centers of many WCRHs in diabetic retinopathy may be platelet-fibrin aggregates.

Adult↗
PubMed2003

Nonophthalmologist accuracy in diagnosing retinal hemorrhages in the shaken baby syndrome.

Nonophthalmologists did not attempt to (36%) or were "unable to" (19%) examine the fundus in 72 children with shaken baby syndrome. When the retina was examined, nonophthalmologists were accurate in recognizing the absence or presence of retinal hemorrhage in 87%. However, false-negative examinations occurred in 13%. Ophthalmology consultation should be an integral part of the evaluation of children with suspected abuse.

Child, Preschool↗
PubMed2003

Meningocele-induced positional syncope and retinal hemorrhage.

Meningocele is recognized as a rare, usually asymptomatic condition not associated with acute neurologic symptoms. We herein describe the case of a patient with a longstanding history of a lower back "mass" and recurrent syncope who became acutely unresponsive and developed bilateral retinal hemorrhages when she was placed in the supine position to undergo carotid sonography. MR imaging revealed a large, dorsal lumbar meningocele. The episode likely was caused by acutely increased intracranial pressure caused by displacement of CSF from the meningocele intracranially.

Aged↗
PubMed2002

Prevalence of retinal hemorrhages and child abuse in children who present with an apparent life-threatening event.

OBJECTIVE: Child abuse (CA) can present with a spectrum of signs and symptoms. Apparent life-threatening events (ALTEs) may be a subtle presentation of CA. Retinal hemorrhages (RHs) are a well-described finding in some patients with CA. We hypothesized that screening children who present with a chief complaint of an ALTE for RH would detect an otherwise occult presentation of CA. METHODS: Children who were younger than 24 months of age and presented to the emergency department between March 1, 1997, and February 28, 1999, with signs and symptoms consistent with the National Institutes of Health's definition of an ALTE were studied prospectively. Children were excluded when it was readily apparent on presentation that the child was a victim of CA. Demographic data, a complete blood count with differential, venous blood gas, carboxyhemoglobin level, and urine toxicological screen were collected. A pediatric ophthalmologist performed a dilated funduscopic examination; patients who were found to have RH underwent a noncontrast computerized tomographic scan of the head and skeletal survey to evaluate for occult injury. Evaluations by social services or Children, Youth and Families, the results of all diagnostic tests obtained, and the final discharge diagnosis were recorded. Medical records of all patients were reviewed at 1 year; subsequent visits, hospitalizations, and evaluations by social services or Children, Youth and Families were recorded. RESULTS: A total of 128 patients presented to the emergency department with an ALTE during the study period. No patients were excluded. Mean age was 2.1 months (median: 1.27; range: 0.07-16.0; standard deviation: 2.1). Fifty-seven (44.5%) were boys; 86 (67.2%) were white, and 36 (27.9%) were black. A total of 26 (20.3%) of 128 patients had a history of an ALTE, 4 (3.4%) of 117 had a family history of an ALTE, and 15 (12.8%) of 117 had a family history of sudden infant death syndrome. Dilated funduscopic examination was performed on 73 (57.0%) of 128 patients; RH was detected in 1 patient (1.4%). Four children, including the patient with RH, underwent an evaluation for suspected abuse; 3 (2.3%) of 128 were determined to have been abused. CONCLUSIONS: RH was detected in 1 (1.4%) of 73 patients in our population of infants with ALTEs and 1 of 3 patients who were victims of CA and presented with an ALTE. CA was detected in 2.3% of patients who presented with an ALTE. The diagnosis of CA should be seriously considered in patients who present with an ALTE. The evaluation of ALTEs should include funduscopic examination as ALTEs and RHs are associated with CA.

Child Abuse↗
PubMed1996

Retinal hemorrhages associated with in utero exposure to cocaine. Experimental and clinical findings.

BACKGROUND: The use of drugs of abuse--e.g., cocaine--during pregnancy has been associated with abnormalities of the visual system. The authors studied the effects of prenatal exposure to drugs of abuse, especially cocaine, on the vascular system of the retina in newborn infants and in an experimental model in the rat. METHODS: The animal study was conducted in pregnant Wistar rats injected subcutaneously with cocaine hydrochloride (60 mg/kg body weight/day) from gestation days 8 to 22. Male offspring were killed at postnatal days 7, 14, and 30 and perfused with fixative, and the retinas were dissected and processed for microscopic observation. The ophthalmologic observations were conducted in a population of newborn infants born to women who abused many drugs during pregnancy and in a control group of women with no history of illicit drug use. RESULTS: Vascular disruptive lesions were seen after prenatal exposure to cocaine in the rat: round intraretinal hemorrhages, ischemic and hypoperfused areas located at the temporal part and often extending from the posterior pole to the periphery of the retina. The ophthalmologic observation of the newborns showed a higher incidence of vascular disruptive lesions in infants in whom exposure to drugs of abuse was affirmative during pregnancy. In the cases in which cocaine consumption was reported, they consisted in blot full-thickness hemorrhages with rounded domed contours suggestive of venous occlusion and retinal ischemia, very similar to the lesions seen in the animal model. These hemorrhagic lesions, morphologically similar to neonatal retinal hemorrhages, had a higher incidence than in controls; they also took longer to resolve when compared with the reabsorption time of the neonatal hemorrhages due to birth trauma and the hemorrhagic lesions in newborns of mothers in whom consumption of other drugs--but not cocaine--were reported. CONCLUSION: A topographic and morphologic parallelism can be established between the retinal vascular alterations found in humans consuming cocaine and in the animal model of prenatal exposure to this drug of abuse; although findings from animal studies may be difficult to apply directly to humans, these data strongly support that cocaine can be a causal factor for the occurrence of retinal vascular disruption in newborns.

Adult↗
PubMed1998

Hyperleukocytosis and retinal hemorrhages after chemotherapy and Filgrastim administration for peripheral blood progenitor cell mobilization.

A 49-year-old man with mantle cell lymphoma received 2.5 g/m2 of cyclophosphamide and 900 mg/m2 of etoposide followed by 10 microg/kg/day of Filgrastim for PBPC mobilization. This was complicated by marked hyperleukocytosis and retinal hemorrhages. The patient's symptoms improved gradually following leukopheresis. To the best of our knowledge, this is the first report describing this complication in patients undergoing PBPC mobilization. Early recognition of symptoms is important in order to stop Filgrastim and initiate immediate leukapheresis.

Filgrastim↗
PubMed1983

Drusen-associated visual field defects and hemorrhages.

Retinal hemorrhages and visual field defects can occur as complications of optic nerve drusen. The visual defects of optic drusen are of three types: (1) concentric constriction of the field, (2) enlargement of the blind spot, and (3) nerve fiber bundle defects. Retinal hemorrhages also fall into three categories: (1) splinter hemorrhages overlying the disk, (2) vitreous hemorrhages, and (3) subretinal hemorrhages. The unusual disk vasculature associated with drusen is probably responsible for the retinal hemorrhages and may be the primary defect in the pathogenesis of drusen. Altered axoplasmic transport and abnormal axonal calcium metabolism have also been thought to be significant in the pathogenesis of drusen.

Adult↗
PubMed1995

Retinal hemorrhage secondary airbag-related ocular trauma.

A case is presented in which a driver, who was wearing a three-point restraint system, was involved in a collision that triggered deployment of the vehicle's driver's-side airbag. The victim complained of blurred vision after the crash and on examination was found to have suffered a retinal hemorrhage in his right eye. Since no other cause could be determined, his injury was considered to be a result of contact with the deploying airbag.

Accidents, Traffic↗
PubMed1998

Small retinal hemorrhages as the only sign of an intracranial aneurysm.

PURPOSE: To report a woman with two small circumpapillary and nerve fiber layer hemorrhages found on routine examination. METHODS: Case report. The patient had a history of severe headache 2 weeks previously but no other symptoms or signs. RESULT: Magnetic resonance imaging showed an intracranial aneurysm. CONCLUSIONS: This potentially lethal abnormality should be considered with small unexplained retinal hemorrhages, even when the neurologic examination is normal. A history of recent headache should be sought.

Adult↗
PubMed1978

Retinal hemorrhages in subacute carbon monoxide poisoning. Exposures in homes with blocked furnace flues.

Three incidences of carbon monoxide poisoning occurred owing to defective heating systems. Twelve persons were affected; of these, three lost their lives. Because the symptoms of carbon monoxide poisoning closely resemble flu and other common illnesses, correct diagnosis was not made as promptly as it might have been. Hemorrhages were found in the nerve fiber layer of the retina in all five of the patients who had been exposed for more than 12 hours. It is our contention, therefore, that complete examination of the patient should always include ohthalmoscopy, and that the finding of retinal hemorrhages, in addition to nausea, headache, and dizziness, should aler the physician to the possibility of carbon monoxide poisoning.

Accidents, Home↗