What is left after resolution of neonatal retinal hemorrhage: The longitudinal long-term outcome in foveal structure and visual function.

Abstract

PURPOSE\nNeonatal retinal hemorrhage (NRH) is one of the most common neonatal fundus conditions. Hemorrhage resolves spontaneously; However, its long-term outcome is unknown yet. The current study explores the long-term role of NRH in foveal structure and visual function.\n\n\nDESIGN\nCohort study PATIENT: 125 healthy newborns during 2013-2015, including 50 newborns with NRH and 75 newborns without NRH, were enrolled. The eyes with NRH were further categorized into the FH group and non-FH group.\n\n\nINTERVENTIONS\nNo.\n\n\nMETHODS\nA prospective longitudinal study, in which the participants were followed up 4-6 years. A comprehensive ophthalmic examination, including best corrected visual acuity (BCVA) measurement, slit-lamp examination, refractive error measurement, Scanning laser ophthalmoscopy, and spectral-domain OCT was performed. Total retinal thickness (TRT) and the inner and outer retinal layers in the fovea were measured and compared.\n\n\nRESULTS\nThe NRH was absorbed within 2.1 ± 0.98 weeks (median: 3 weeks). No difference was noted in the demographic characteristics between the groups; there was no significant difference in the logMAR BCVA (p=0.83) or in the TRT. Subgroup analysis showed that TRT at the fovea (CRT) in the FH group was significantly thicker (p=0.005). Segmentation analysis showed a significantly thicker foveal outer nuclear layer (ONL) in the FH group (p=0.017).\n\n\nCONCLUSIONS\nBirth-related retinal hemorrhage, even foveal hemorrhage, might not lead to obvious visual abnormalities at the age of 4 years, at least according to this study with relative small sample size. However, a thicker fovea, mainly attributed to a wider ONL and a shallower foveal pit are noted in our study.