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Retinal, vitreous hemorrhage may be factor in postop retinal detachment in ROP
Retina. 2008;28(10):1451-1457.
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The presence of retinal or vitreous hemorrhage before photocoagulation for retinopathy of prematurity may be an important warning sign for postsurgical retinal detachment.
According to a review of 184 eyes of 94 patients, retinal detachment occurred in six of 154 eyes without pre-existing retinal or vitreous hemorrhage, but in 10 of 30 eyes with a diagnosis of hemorrhage before surgery.
"In addition, vitreous organization and persistent active element of plus disease 21 days after treatment were also associated with retinal detachment," the study authors said.
Hemorrhage occurred postoperatively in 13 eyes. Regression of disease occurred in nine of these eyes, of which two developed a retinal detachment. Regression of disease did not occur in four eyes, and detachment occurred in all four.
"The regression of the plus disease appears to an important prognostic sign in patients with posttreatment hemorrhage," the authors said.
Intraocular hemorrhage in an infant with ROP increases the risk of progression to retinal detachment. While this finding may simply be from an association of hemorrhage with more severe ROP, it would seem more likely that the hemorrhage may lead to intravitreal and/or preretinal organization with resultant traction on the retina. Further study controlling for ROP severity or performing intrapatient comparisons may help clarify this relationship.
– Michael X. Repka, MD
Johns Hopkins University School of Medicine,