Objective: To report results of early ophthalmologic examinations in a large cohort of preterm newborns with fundus hemorrhage not associated with ROP in Chinaafter neonatal screening.
Participants: A total of 7,039 preterm newborns, with fundus hemorrhage not secondary to retinopathy of prematurity (ROP), were screened in Peking University People’s Hospital inBeijing.
Methods: From Jaunary 1, 2003, through Nov 31, 2011, preterm newborns underwent neonatal ocular examination according to the guideline for screening ROP of China and a comprehensive medical history was reviewed.
Main Outcome Measures: Prevalence of fundus hemorrhage not associated with ROP, the situation of fundus hemorrhage and potential perinatal risks were evaluated.
Results: Of 7,260 preterm neonates screened, 82(1.13%) infants, 104 eyes (0.72%) had fundus hemorrhage. According to the classification of perinatal retinal hemorrhage 59 infants (77 eyes) had flame-shaped superficial hemorrhages, 4 infants (4 eyes) had large round hemorrhages located in the posterior pole and one or two disc diameters in size, and 2 of whose hemorrhage was so dense that a surgery was carried out. 6 infants (6 eyes) had small round hemorrhages at the posterior pole.12 infants (16 eyes) had vitreous hemorrhage and for 1 eye whose hemorrhage was dense, a vitrectomy surgery was performed.
Conclusions: The rate of fundus hemorrhage was considerable in preterm newborns. Since no association was found between the hemorrhage and ROP, we assumed similar situation could happen in term infants. Birth trauma is the most common cause. Most superficial hemorrhage could absorb itself without leaving any obvious ocular damage. Since different kinds of damage to the vision could happen, we recommend that neonates at increased risk be examined for hemorrhages with macular involvement, and surgery intervention is necessary for cases with obvious vitreous or macular hemorrhage.