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Ocular findings in premature infants with grade IV intraventricular hemorrhage
1Department of Ophthalmology, Loyola University Medical Center, Maywood, Ill. 60153.
Insights
Infants with severe brain bleeds (grade IV intraventricular hemorrhage) face a higher risk of serious eye problems and vision loss. Early and regular eye exams are crucial for these premature infants.
Area of Science:
- Neonatal ophthalmology
- Perinatal neurology
- Pediatric neuro-ophthalmology
Background:
- Grade IV intraventricular hemorrhage (IVH) is a significant complication in premature infants.
- Ocular complications can arise in premature infants, impacting visual development.
- The long-term visual outcomes for infants with severe IVH require further investigation.
Purpose of the Study:
- To compare ocular findings in infants with grade IV IVH versus premature infants without IVH.
- To determine the incidence of ocular abnormalities and severe visual loss in these groups.
- To establish the necessity for early and frequent ophthalmologic examinations in high-risk infants.
Main Methods:
- Retrospective analysis of serial ocular examinations in 13 infants with grade IV IVH.
- Comparison group included 11 premature infants matched for gestational age and birth weight, without IVH.
- Ophthalmologic exams were conducted within 8 weeks of birth and periodically until 3–7 years of age.
Main Results:
- Incidence of ocular abnormalities was 92% in the grade IV IVH group versus 73% in the control group.
- A statistically significant increase in severe eye disease and visual loss (38%) was observed in the grade IV IVH group.
- Causes of vision loss included optic atrophy and retinopathy of prematurity.
Conclusions:
- Infants with grade IV IVH exhibit a high incidence of ocular abnormalities and visual impairment.
- Severe eye disease leading to vision loss is more prevalent in infants with grade IV IVH.
- Early and frequent ophthalmologic evaluations are essential for managing visual risks in these infants.
Abstract:
Grade IV intraventricular hemorrhage (IVH) is a severe complication of premature birth. We retrospectively performed serial exams on 13 infants with grade IV IVH and compared their ocular findings to 11 infants matched by gestational age and birth weight without an IVH. All children in the study were initially examined in the neonatal unit within 8 weeks after birth. Subsequent periodic eye exams were performed until 3 to 7 years of age. Of the 13 grade IV IVHs, there was a 92% incidence of ocular abnormalities, compared to a 73% incidence in the premature group without IVH. The children with grade IV hemorrhages had a statistically significant increased incidence of severe eye disease with resultant visual loss (38%) compared to the non-IVH group. Loss of vision was due to optic atrophy and retinopathy of prematurity. Grade IV IVH children are at high risk for severe eye disease and should have early and frequent ophthalmologic exams.