Circumferential retinal hemorrhages after ophthalmic examination with scleral depression in an infant with anti-VEGF treated retinopathy of prematurity.

Abstract

We report a case of retinal hemorrhages in a baby with retinopathy of prematurity (ROP) following examination with indirect ophthalmoscopy and scleral depression. There have been rare reports of examination-induced retinal hemorrhages during ROP screening, although those hemorrhages were diffusely scattered in the posterior pole. In this report the hemorrhages were found on the surface of the neovascular ridge. Changes in intraocular pressure caused by scleral depression may result in rupture of the fragile and immature retinal vessels, which have poor autoregulation in these premature babies. Ophthalmologists performing ROP screening examinations should be aware of the possibility of causing retinal hemorrhages with scleral depression, although the hemorrhages will resolve spontaneously.

• Authors: Rehan M Hussain, Kimberly D Tran, Supalert Prakhunghunsit, Brenda Fallas, Catherin I Negron, Ana Rodriguez, Audina M Berrocal
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 23 Issue 5 Pg. 293-295 (10 2019) ISSN: 1528-3933 [Electronic] United States
• PMID: 31145988 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2019. Published by Elsevier Inc.

Chemical References

• Angiogenesis Inhibitors
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Bevacizumab

Topics

• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Female
• Follow-Up Studies
• Gestational Age
• Humans
• Infant
• Infant, Extremely Low Birth Weight
• Intravitreal Injections
• Photography
• Physical Examination (adverse effects)
• Retinal Hemorrhage (diagnosis, etiology)
• Retinopathy of Prematurity (diagnosis, drug therapy)
• Sclera (pathology)
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)