Vitreous hemorrhage in patients with high-risk retinopathy of prematurity.
OBJECTIVE
To investigate outcomes in premature infants with high-risk retinopathy of prematurity and secondary vitreous hemorrhage.


METHODS
Retrospective chart review.


METHODS
Patients were selected from a database of infants undergoing retinopathy of prematurity screening from September 1997 to November 1999. Infants with high-risk retinopathy of prematurity (zone I or posterior zone II threshold disease) with and without vitreous hemorrhage were compared.


METHODS
Final stage of retinopathy of prematurity and short-term structural outcome were assessed. Visual acuity and refraction were measured when possible.


RESULTS
Twenty-two eyes of 11 patients (group 1) had high-risk (posterior zone II or zone I threshold) retinopathy of prematurity without vitreous hemorrhage. Group 1 patients had a 91% favorable short-term structural outcome. Eight eyes of five infants developed vitreous hemorrhage with high-risk retinopathy of prematurity (group 2). Group 2 patients had only a 12.5% favorable short-term structural outcome. Seven of eight (87.5%) progressed to stage IVa or IVb retinopathy of prematurity. Six eyes underwent vitreoretinal surgery after a median duration of hemorrhage of 36 +/- 29 days (4-70 days). Three eyes developed stage V detachments and three progressed to phthisical degeneration. Final visual acuity was no light perception in three eyes.


CONCLUSIONS
Vitreous hemorrhage, in association with advanced retinopathy of prematurity, is a poor prognostic sign.
Hutcheson
Kelly A
KA
Department of Ophthalmology, Childrens National Medical Center and George Washington University School of Medicine, Washington, DC 20010, USA. kellyhutcheson@hotmail.com
Nguyen
Ahn T Q
AT
Preslan
Mark W
MW
Ellish
Nancy J
NJ
Steidl
Scott M
SM
D001724:Birth Weight; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011379:Prognosis; D012029:Refraction, Ocular; D012163:Retinal Detachment / Q000209:etiology; D012178:Retinopathy of Prematurity / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity; D014823:Vitreous Hemorrhage / Q000209:etiology* / Q000503:physiopathology