TY - JOUR
T1 - Visual and anatomic outcomes of premacular hemorrhage in non-accidental trauma infants managed with observation or vitrectomy
AU - Uner, Ogul E.
AU - Stelton, Christopher R.
AU - Hubbard, G. Baker
AU - Rao, Prethy
N1 - Funding Information:
Originally submitted July 29, 2020. Revision received September 20, 2020. Accepted for publication October 7, 2020. A preliminary version of this manuscript was presented June 7, 2014, at Resident Research Day, Emory Eye Center in Atlanta, Georgia, and again in poster format on May 7, 2015, at The Association for Research in Vision and Ophthalmology (ARVO) Annual Meeting in Denver, Colorado. Supported by National Eye Institute Core Grant P30 EY006360. Dr. Rao is a consultant for and receives royalties from Vortex Surgical outside the submitted work. The remaining authors report no relevant financial disclosures. Address correspondence to Prethy Rao, MD, MPH, Department of Ophthalmology, Emory University, 1365B Clifton Road, Atlanta, GA 30322; email: prethy.rao@emory.edu. doi: 10.3928/23258160-20201202-06
Publisher Copyright:
© 2020 Slack Incorporated. All rights reserved.
PY - 2020/12
Y1 - 2020/12
N2 - BACKGROUND AND OBJECTIVE: The management of premacular hemorrhage secondary to non-accidental trauma (NAT) is unclear. The authors describe the outcomes of NAT infants referred for surgical evaluation of premacular hemorrhage. PATIENTS AND METHODS: Retrospective institutional review board-approved case series between 2000 and 2019 of vision-threatening premacular hemorrhage (sub-hyaloid or sub-internal limiting membrane hemorrhage without vitreous hemorrhage) in NAT infants. Time to hemorrhage resolution, vision, and comorbidities were collected. RESULTS: Thirty-six patients (62 eyes) with mean age of 5.4 months (range: 2-10 months) were included. Nine eyes (14.5%) underwent vitrectomy. Median time to hemorrhage resolution by observation was 75 days (interquartile range [IQR]: 60-120 days), and time to vitrectomy was 54.5 days (IQR: 47.8-58.5 days). Eight eyes (12.9%) had amblyopia, which was not significantly different between groups. Despite hemorrhage clearance, a higher proportion of eyes in the vitrectomy group had pigmentary changes (P = .04) and strabismus (P = .002) at follow-up. CONCLUSIONS: Most cases of NAT-related premacular hemorrhage resolve within 3 months without surgical intervention. Comorbidities may limit visual prognosis.
AB - BACKGROUND AND OBJECTIVE: The management of premacular hemorrhage secondary to non-accidental trauma (NAT) is unclear. The authors describe the outcomes of NAT infants referred for surgical evaluation of premacular hemorrhage. PATIENTS AND METHODS: Retrospective institutional review board-approved case series between 2000 and 2019 of vision-threatening premacular hemorrhage (sub-hyaloid or sub-internal limiting membrane hemorrhage without vitreous hemorrhage) in NAT infants. Time to hemorrhage resolution, vision, and comorbidities were collected. RESULTS: Thirty-six patients (62 eyes) with mean age of 5.4 months (range: 2-10 months) were included. Nine eyes (14.5%) underwent vitrectomy. Median time to hemorrhage resolution by observation was 75 days (interquartile range [IQR]: 60-120 days), and time to vitrectomy was 54.5 days (IQR: 47.8-58.5 days). Eight eyes (12.9%) had amblyopia, which was not significantly different between groups. Despite hemorrhage clearance, a higher proportion of eyes in the vitrectomy group had pigmentary changes (P = .04) and strabismus (P = .002) at follow-up. CONCLUSIONS: Most cases of NAT-related premacular hemorrhage resolve within 3 months without surgical intervention. Comorbidities may limit visual prognosis.
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U2 - 10.3928/23258160-20201202-06
DO - 10.3928/23258160-20201202-06
M3 - Article
C2 - 33339053
AN - SCOPUS:85098744987
VL - 51
SP - 715
EP - 722
JO - Ophthalmic surgery, lasers & imaging retina
JF - Ophthalmic surgery, lasers & imaging retina
SN - 2325-8160
IS - 12
ER -