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Conditions in which retinal haemorrhages are proposed to occur

The following is a summary of the systematic review findings up to the date of our most recent literature search. If you have a specific clinical case, we strongly recommend you read all of the relevant references as cited and look for additional material published outside our search dates.

 

Seizures

  • Five studies examined children with seizures, reflecting 397 children 2,6,9-11
  • 235 cases had febrile seizures; the remaining cases included epilepsy, metabolic disease, infection or CVA 2,6,9-11
  • Retinal haemorrhages were only recorded in two cases 6,9
    • Mei-Zahav et al 6 ; an infant with generalised seizure and no other risk factors who had flame-shaped haemorrhages in the posterior pole unilaterally
    • Rubin et al 9 – single case report of an infant with hyponatremia and prolonged seizure who had multiple retinal haemorrhages in the posterior poles bilaterally

 

Apparent life-threatening events

  • 292 cases in children aged less than two years old were examined 1,3,8
  • No retinal haemorrhages were found in any children examined

 

Prolonged coughing

  • 135 cases in children aged less than two years old were examined 4,5
  • No retinal haemorrhages were found in any children examined

 

Cardiopulmonary resuscitation

  • A single study met our inclusion criteria: 43 children were examined following resuscitation
  • One infant was noted to have bilateral, numerous, punctuate haemorrhages.  However, this child also had one hour of open chest cardiac massage with deranged clotting and platelet counts 7

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References

  1. Altman RL, Forman S, Brand DA. Ophthalmologic findings in infants after an apparent life-threatening event. European Journal of Ophthalmology. 2007;17(4):648-653 [Pubmed]
  2. Curcoy AI, Trenchs V, Morales M, Serra A, Pineda M, Pou J. Do retinal haemorrhages occur in infants with convulsions? Archives of Disease in Childhood. 2009;94(11):873-5 [Pubmed]

  3. Curcoy A, Trenchs V, Morales M, Serra A, Pou J. Retinal hemorrhages and apparent life-threatening events. Pediatric Emergency Care. 2010;26(2):118-120 [Pubmed]

  4. Curcoy AI, Trenchs V, Morales M, Serra A, Pou J. Is pertussis in infants a potential cause of retinal haemorrhages? Archives of Disease in Childhood. 2012;97(3):239-240 [Pubmed]

  5. Goldman M, Dagan Z, Yair M, Elbaz U, Lahat E, Yair M. Severe cough and retinal hemorrhage in infants and young children. The Journal of Pediatrics. 2006;148(6):835-836 [Pubmed]
  6. Mei-Zahav M, Uziel Y, Raz J, Ginot N, Wolach B, Fainmesser P. Convulsions and retinal haemorrhage: should we look further? Archives of Disease in Childhood. 2002;86(5):334-335 [Pubmed]
  7. Odom A, Christ E, Kerr N, Byrd K, Cochran J, Barr F, Bugnitz M, Ring JC, Storgion S, Walling R, Stidham G, Quasney MW. Prevalence of retinal hemorrhages in pediatric patients after in-hospital cardiopulmonary resuscitation: a prospective study. Pediatrics. 1997;99(6):E3 [Pubmed]
  8. Pitetti RD, Maffei F, Chang K, Hickey R, Berger R. Pierce MC. Prevalence of retinal hemorrhages and child abuse in children who present with an apparent life-threatening event. Pediatrics. 2002;110(3):557-562 [Pubmed]
  9. Rubin D, Christian C. Retinal hemorrhages in infants with hyponatremic seizures. Pediatric Emergency Care. 2001;17(4):313-314 [Pubmed]
  10. Sandramouli S, Robinson R, Tsaloumas M, Willshaw HE. Retinal haemorrhages and convulsions. Archives of Disease in Childhood. 1997;76(5):449-451 [Pubmed]
  11. Tyagi AK, Scotcher S, Kozeis N, Willshaw HE. Can convulsions alone cause retinal haemorrhages in infants? British Journal of Ophthalmology. 1998;82(6):659-660 [Pubmed]

 

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