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Bilateral vitreous hemorrhages in an infant with low fibrinogen levels

W E Marshman1, G G Adams, R Ohri

  • 1Strabismus and Paediatric Service, Moorfields Eye Hospital, London, United Kingdom.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|September 7, 1999
PubMed

Insights

A rare blood clotting disorder, low plasma fibrinogen, caused severe retinal and vitreous hemorrhages in an infant. This finding challenges the assumption of nonaccidental injury in such cases.

Area of Science:

  • Ophthalmology
  • Hematology
  • Pediatrics

Background:

  • Retinal and vitreous hemorrhages in young children often raise concerns for nonaccidental injury.
  • Blood dyscrasias are known causes of retinal hemorrhages, but rarely reported in neonates.

Observation:

  • A case of a neonate presenting with bilateral retinal hemorrhages that progressed to vitreous hemorrhages.
  • The infant had a documented low plasma fibrinogen level, indicating a subtle blood clotting abnormality.

Findings:

  • The low plasma fibrinogen level was identified as the cause of the severe retinal and vitreous hemorrhages.
  • The infant had no identifiable risk factors for abuse, highlighting an alternative etiology.

Implications:

  • This case underscores the importance of considering hematological causes, such as fibrinogen deficiency, in neonates with retinal hemorrhages.
  • Accurate diagnosis can prevent misinterpretation as nonaccidental injury, ensuring appropriate medical management and family support.

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