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Retinal features

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.

 

  • There was a lack of standardisation in the recording of retinal features among included studies

Severity

  • Where severity of retinal haemorrhages was noted the findings varied, with mild, moderate and severe retinal haemorrhages being recorded 2,3,5,7-14

Size of retinal haemorrhages

  • Size of retinal haemorrhages was recorded in seven studies and the majority were found to be small 3,8,9-13

Layer

  • Six studies recorded the layer in which haemorrhages occurred 1,3,5,7,9,14 which were intraretinal for all cases apart from a single subretinal haemorrhage 5

Laterality

  • Five studies reported the laterality of the haemorrhages 1,5-7,9, which were more commonly bilateral but with 22-48% occurring unilaterally

Location

  • Haemorrhages were predominantly found in the posterior pole 2,3,5-8,9,14 with two studies recording haemorrhages to the periphery 5,9

 Outcome

  • Three studies conducted follow-up examinations and noted that the majority resolved within two weeks, with 97% resolved by 42 days 5,7,9. In two subjects haemorrhages were still present at 31 and 58 days, respectively 7

Additional findings

  • One study examined the role of handheld spectral-domain optical coherence tomography (SD-OCT). They noted the presence of bilateral subfoveal fluid in six infants. Follow up SD-OCT at one month of age showed resolution in 2/3 infants, and resolution in the remaining case by two months 3
  • A further study of 20 Hispanic infants utilising OCT noted 10% had sub-retinal fluid and 10% had cystoid macular oedema 4

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References

  1. Bergen R, Margolis S. Retinal hemorrhages in the newborn. Annals of Ophthalmology. 1976;8(1):53-56 [Pubmed]
  2. Berkus MD, Ramamurthy RS, O'Connor PS, Brown K, Hayashi RH. Cohort study of silastic obstetric vacuum cup deliveries: I. Safety of the instrument. Obstetrics and Gynecology. 1985;66(4):503-509 [Pubmed]
  3. Cabrera MT, Maldonado RS, Toth CA, O'Connell RV, Chen BB, Chiu SJ, Farsiu S, Wallace DK, Stinnett SS, Panayotti GM, Swamy GK, Freedman SF. Subfoveal fluid in healthy full-term newborns observed by handheld spectral domain optical coherence tomography. American Journal of Ophthalmology. 2012;153(1):167-175. [Pubmed]

  4. Cabrera MT, O'Connell RV, Toth CA, Maldonado RS, Tran-Viet D, Allingham MJ, Chiu SJ, Farsiu S, Panayotti GM, Swamy GK, Freedman SF. Macular findings in healthy full-term Hispanic newborns observed by hand-held spectral-domain optical coherence tomography. Ophthalmic Surgery, Lasers & Imaging Retina. 2013;44(5):448-454 [Pubmed]

  5. Emerson MV, Pieramici DJ, Stoessel KM, Berreen JP, Gariano RF. Incidence and rate of disappearance of retinal hemorrhage in newborns. Ophthalmology. 2001;108(1):36-39 [Pubmed]
  6. Gonzalez Viejo I, Ferrer Novella C, Pueyo Subias M, Ronchera Oms JM, Bueno Lozano J, Ferrer Novella E, Vicente Aznar E, Honrubia Lopez FM. Hemorrhagic retinopathy in newborns: frequency, form of presentation, associated factors and significance. European Journal of Ophthalmology. 1995;5(4):247-250 [Pubmed]
  7. Hughes LA, May K, Talbot JF, Parsons MA. Incidence, distribution, and duration of birth-related retinal hemorrhages: a prospective study. Journal of AAPOS: American Association for Pediatric Ophthalmology and Strabismus. 2006;10(2):102-106 [Pubmed]
  8. Kuit JA, Eppinga HG, Wallenburg HC, Huikeshoven FJ. A randomized comparison of vacuum extraction delivery with a rigid and a pliable cup. Obstetrics and Gynecology. 1993;82(2):280-284 [Pubmed]
  9. Schoenfeld A, Buckman G, Nissenkorn I, Cohen S, Ben-Sira I, Ovadia J. Retinal hemorrhages in the newborn following labour induced by oxytocin or dinoprostone. Archives of Ophthalmology. 1985;103(7):932-934 [Pubmed]
  10. Svenningsen L, Eidal K. Lack of correlation between umbilical artery pH, retinal hemorrhages and Apgar score in the newborn. Acta Obstetricia et Gynecologica Scandinavica. 1987;66(7):639-642 [Pubmed]
  11. Svenningsen L, Lindemann R, Eidal K, Jensen O. Neonatal retinal hemorrhages and neurobehavior related to tractive force in vacuum extraction. Acta Obstetricia et Gynecologica Scandinavica. 1987;66(2):165-169 [Pubmed]
  12. Svenningsen L, Eidal K. Retinal hemorrhages and traction forces in vacuum extraction. Early Human Development. 1988;16(2-3):263-269 [Pubmed]
  13. Svenningsen L, Lindemann R, Eidal K. Measurements of fetal head compression pressure during bearing down and their relationship to the condition of the newborn. Acta Obstetricia et Gynecologica Scandinavica. 1988;67(2):129-133 [Pubmed]
  14. Williams MC, Knuppel RA, O'Brien WF, Weiss A, Spellacy WN, Pietrantoni M. Obstetrics correlates of neonatal retinal hemorrhage. Obstetrics and Gynecology. 1993;81(5 (part 1)):688-694 [Pubmed]

 

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