Fundus Hemorrhages in Infancy

Citation:

Kaur B, Taylor D: Fundus hemorrhages in infancy. Survey of Ophthalmology 37(1):1-17, July-August 1992.

Abstract

Notes:

• Things retinal hemorrhages in infancy may indicate:
  • Intracranial aneurysms
  • Accidental or non-accidental injury
  • Coats' disease
  • PHPV
  • ROP
  • Retinal dysplasia
  • Hypertension
  • Myopia
  • Hematologic or cardiovascular disorders
  • Infection
  • Protein C deficiency
  • Sickle cell disease
  • Leukemia
  • Retinopathy of prematurity
  • Angiomatosis retinae
  • Blood dyscrasias with panctopenia, anemia and coagulopothies
  • Vitamin C, vitamin E and vitamin K deficiency states.
• A table in the article describes difference in the frequency, shape and size of hemorrhages of different origin.
• The mortality rate is twice as high when intraocular hemorrhages are present.
• The Valsalva maneuver or anything forcibly contracting the chest may cause "Valsalva's hemorrhagic retinopathy".
• A "posterior interhemispheric distribution" of retinal hemorrhages is characteristic of shaking injury.
• Unless there is parenchymal injury, retinal hemorrhages with localized intracerebral hematoma may not be traumatic.
• "Sometimes, attempted resuscitation of a lethargic child by shaking the infant causes to and fro flexions of the head and may result in intracranial and intraocular hemorrhages and death." (p. 12)
• "Retinal hemorrhages occur in up to 89% of infants who have suffered child abuse. Perimacular folds may be pathognomonic of child abuse by shaking, but retinal hemorrhages cannot by themselves be taken as being pathognomonic of child abuse." (p. 14)

Return to Shaken Baby Syndrome Medical Articles
Source: www.SusanCAnthony.com