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Study: Good outcomes from nonsurgical vitreous hemorrhage management in children with ROP
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SEATTLE — Children who experience late vitreous hemorrhage can achieve good visual outcomes with observation, but surgical intervention may be warranted for those with pre-existing retinal pathology, according to a pediatric ophthalmologist speaking here.
Adrienne L. Ruth, MD, and colleagues reviewed the charts for all patients who presented to their center with a vitreous hemorrhage between 1995 and 2006. The study included 14 eyes of 13 children who had a history of regressed retinopathy of prematurity (ROP).
These 13 children had a mean follow-up of 11.9 months. Dr. Ruth described their characteristics at the American Association for Pediatric Ophthalmology and Strabismus meeting.
Overall, eight eyes (57%) received observation and six eyes (43%) underwent vitrectomy. Of these six eyes, surgeons performed vitrectomy in two because of associated retinal detachments, in three for posterior vitreous detachments or vitreoretinal traction and in one for a non-clearing vitreous hemorrhage, Dr. Ruth said.
Most patients treated with observation maintained their baseline visual acuity once their vitreous hemorrhage resolved. However, the visual prognosis was worse for children who required surgery, she noted.
"The baseline visual acuity and severity of pathology of this [surgery] group were worse as a whole," she said.
Dr. Ruth and colleagues recommended that all children with stage 3 or higher ROP undergo annual exams with ultrasound as needed to detect retinal detachment or tears. Vitrectomy is only indicated for non-clearing vitreous hemorrhage or if a retinal detachment is found, she noted.