Lens-sparing vitreous surgery for infantile amblyogenic vitreous hemorrhage.
OBJECTIVE
To report on a series of infants with amblyogenic vitreous and/or subinternal limiting membrane hemorrhage managed by lens-sparing vitrectomy.


METHODS
Retrospective case series studying retinal attachment status and visual acuity.


RESULTS
Eleven eyes sustained vitreous hemorrhage as a consequence of shaken baby syndrome, 1 due to hyaloidal canal hemorrhage extending into the vitreous, 1 due to Terson syndrome, 1 due to birth trauma, and 2 due to a presumed coagulation disorder. Age of the patients at the time of surgery ranged from 2 to 23 months (age adjusted for prematurity). Follow-up ranged from 7 to 81 months (mean, 28 months). Ten eyes had visual improvement. Two infants with shaken baby syndrome had bilateral nonrecordable flash visual evoked potential before surgery; one eye of one infant had a better than expected visual outcome after surgery. One eye sustained a retinal tear without detachment. One eye in an infant with severe shaken baby syndrome and traumatic retinopathy developed a total rhegmatogenous retinal detachment with proliferative vitreoretinopathy.


CONCLUSIONS
Infantile amblyogenic vitreous hemorrhage may be effectively managed by lens-sparing vitreous surgery. Visual outcome of shaken baby syndrome may be limited as a consequence of structural damage to the retina, optic nerve, or posterior visual pathways.
Capone
Antonio
A
Associated Retinal Consultants, P.C., Royal Oak, Michigan 48073, USA. acaponejr@yahoo.com
D000550:Amblyopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005074:Evoked Potentials, Visual / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007908:Lens, Crystalline / Q000502:physiology*; D010775:Photic Stimulation; D012160:Retina / Q000502:physiology; D012166:Retinal Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D038642:Shaken Baby Syndrome / Q000150:complications; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*