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Ocular findings in infants treated with extracorporeal membrane oxygenator support
M C Patrias1, I M Rabinowicz, M D Klein
1Department of Ophthalmology, Wayne State University School of Medicine, Detroit, MI.
Insights
Extracorporeal membrane oxygenation (ECMO) can cause unilateral ocular vascular changes in infants. These findings may be linked to specific vessel occlusions and altered cerebral blood flow dynamics.
Area of Science:
- Neonatal Medicine
- Ophthalmology
- Pediatric Cardiology
Background:
- Infants undergoing extracorporeal membrane oxygenation (ECMO) are at risk for various complications.
- Ocular complications, particularly vascular changes, have been reported but not fully understood.
Purpose of the Study:
- To investigate the incidence and characteristics of ocular complications in infants receiving ECMO.
- To explore the potential mechanisms behind observed unilateral vascular changes.
Main Methods:
- Retrospective examination of ocular findings in eleven infants treated with ECMO.
- Correlation of ocular findings with vascular status, specifically right common carotid and internal jugular occlusion.
Main Results:
- Four out of eleven infants exhibited unilateral retinal and external ocular vascular changes, predominantly on the left side.
- These unilateral findings were associated with right common carotid and internal jugular occlusion.
Conclusions:
- Unilateral ocular vascular changes in ECMO-treated infants may be linked to specific vascular occlusions.
- Proposed mechanisms include cerebral venous congestion, impaired autoregulation, and asymmetrical cerebral blood flow.
Abstract:
Eleven infants treated with extracorporeal membrane oxygenator support were examined for ocular complications. Four patients were noted to have retinal and external ocular vascular changes on the left but not on the right. These unilateral findings are believed to be related to right common carotid and internal jugular occlusion. The proposed mechanism involves three factors: cerebral venous congestion, impairment of cerebral and possibly retinal arterial autoregulation, and higher cerebral arterial blood flow on the left compared with the right.