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Late vitreous hemorrhage in patients with regressed retinopathy of prematurity
Adrienne Ruth1, Amy K Hutchinson, G Baker Hubbard
1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
Late vitreous hemorrhage can occur years after retinopathy of prematurity (ROP) resolves. This condition in children may stem from vitreoretinal traction, even without active disease or trauma, and vision is often preserved with proper management.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Retinal Diseases
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Regressed ROP can present with late complications years after the active phase.
- Vitreous hemorrhage is a serious complication that can impair vision.
Purpose of the Study:
- To characterize eyes experiencing late vitreous hemorrhage in children with a history of regressed retinopathy of prematurity (ROP).
- To understand the underlying causes and outcomes of this condition.
Main Methods:
- Retrospective review of medical records for patients with regressed ROP and late vitreous hemorrhage.
- Analysis of patient demographics, ROP stage, prior treatments, and clinical presentation at the time of hemorrhage.
Main Results:
- 13 patients (14 eyes) with stage 3 or higher ROP were identified.
- Hemorrhage occurred between 10.8 months and 15 years of age (mean 8.4 years).
- No active neovascularization was present; trauma and retinal detachment were noted in some cases, but eight eyes had no apparent cause.
Conclusions:
- Late vitreous hemorrhage is a potential complication of regressed ROP, often years after resolution.
- The cause is likely vitreoretinal traction on residual scar tissue or normal vessels.
- Vitreous hemorrhage can occur without trauma, tears, detachment, or active neovascularization.
- Most patients maintained baseline vision with appropriate management, including observation or vitrectomy.
Purpose:
To describe the characteristics of eyes with late vitreous hemorrhage in children with a history of regressed retinopathy of prematurity (ROP).
Methods:
The medical records of consecutive patients with regressed ROP presenting to our institution with late vitreous hemorrhage between 1995 and 2006 were reviewed.
Results:
Thirteen patients (14 eyes) were identified. All patients had stage 3 or higher ROP. Prior treatments included cryotherapy in three eyes, laser ablation in eight eyes, and laser followed by vitrectomy for retinal detachment in two eyes. Three eyes had had no prior ocular surgery. Age at late vitreous hemorrhage ranged from 10.8 months to 15 years (mean, 8.4 years). At the time of late vitreous hemorrhage, no eyes had active neovascularization, three eyes had a history of trauma, and three eyes had concurrent retinal detachment; eight eyes were observed (57%) and six (43%) were treated with vitrectomy.
Conclusions:
Late vitreous hemorrhage can occur in patients with regressed ROP years after the vascularly active phase of the disease. It likely results from abnormal vitreoretinal traction on otherwise normal retinal vessels or from a normal amount of traction on residual cicatricial tissue. Vitreous hemorrhage may occur in the absence of trauma, retinal tears, retinal detachment, or active neovascularization. With appropriate management, most patients maintained their baseline vision.
