VITREOUS HEMORRHAGE FROM CARBON MONOXIDE RETINOPATHY

To report the observation of a case of carbon monoxide poisoning in a 5-year-old child causing significant vision loss, retinal hemorrhages, and bilateral vitreous hemorrhage.

A 5-year-old male patient underwent ophthalmologic examination including indirect ophthalmoscopy with a 20D lens, slit-lamp biomicroscopy, and bilateral 25 gauge pars plana vitrectomies.

The patient did not fix and follow, but did blink in response to bright light. Pupils were reactive without afferent pupillary defect. Anterior examination was unremarkable and intraocular pressures were normal. Dilated funduscopic examination showed diffuse white, fluffy appearing vitreous haze bilaterally overlying the macula with scattered retinal hemorrhages and Roth spots throughout both retinas. The patient subsequently underwent 25 gauge pars plana vitrectomies in each eye, and findings during surgery were suggestive of vitreous hemorrhage in both eyes. Vitreous biopsy did not reveal any infectious or inflammatory cells.

This is the second case of carbon monoxide poisoning causing vitreous changes. Given our findings, along with retinal hemorrhages, disk edema, retinal vein tortuosity, and internal limiting membrane hemorrhages, vitreous hemorrhage can be included as a manifestation of carbon monoxide retinopathy.