July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Analysis of newborn retinal haemorrhage in a tertiary hospital in Sao Paulo, Brazil with Retcam 3 fundus photos.
Author Affiliations & Notes
  • Murilo Ubukata Polizelli
    Ophthalmology Resident, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
  • Bruno Mauricio Rodrigues de Oliveira
    Ophthalmology Resident, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
  • Luis Nakayama
    Retina fellow at University of São Paulo, Brazil
  • Vinicius Bergamo
    Retina fellow at University of São Paulo, Brazil
  • Nilva Simeren Bueno de Moraes
    Professor at University of São Paulo, Brazil
  • Footnotes
    Commercial Relationships   Murilo Polizelli, None; Bruno Oliveira, None; Luis Nakayama, None; Vinicius Bergamo, None; Nilva Moraes, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3974. doi:
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      Murilo Ubukata Polizelli, Bruno Mauricio Rodrigues de Oliveira, Luis Nakayama, Vinicius Bergamo, Nilva Simeren Bueno de Moraes; Analysis of newborn retinal haemorrhage in a tertiary hospital in Sao Paulo, Brazil with Retcam 3 fundus photos.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3974.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : This study analyse the newborn retinal haemorrhage (RH) in a tertiary hospital in Sao Paulo and evaluate the association of these findings with maternal comorbidities, pre-natal conditions and health conditions of the newborn.

Methods : The study took place in the Hospital of Sao Paulo, Brazil between october and november 2018. All newborns delivered with clinical conditions to undergo the exam were included. An informed consent was signed before the exam.
Pupillary dilatation was achieved with one drop of 0,5% tropicamide and 2,5% phenylephrine, anesthesia was performed with 0,5 % proxymetacaine drops an infant speculum was used to open the eyelid. Indirect fundoscopy was performed, for the fundus photos with the Retcam 3 50mg/m dexpantenol gel was used and the fundus was recorded with a 1300D lens.The exams were performed between 1 and 4 days after the delivery.
The RH were classified according to the Egge method (9).

Results : 34 newborns were examined, the average gestational age was 38,1 ± 1,4 weeks, the average birth weight was 2963 ± 512g and the female:male ratio was 1.8:1. Regarding the delivery mode 20 (59%) were caesarean section and 14 (41%) were vaginal.
19 (29,6%) eyes had RH. 16 (25%) of those were classified as Grade III, 1 (1,5%) as Grade II and 2 (3.1%) as Grade I.
7 (20%) newborns with bilateral Grade III RH, and 1 (2,9%) with unilateral compromised foveal area. There was 1 newborn with preretinal subhyaloid haemorrhage. 1 (2%) newborn with bilateral optic nerve hypoplasia with no systemic diseases. Among the vaginal delivery newborns 14 (41%) had RH, for the caesarian section, 5 (25%) had RH. 44% of the Grade III RH were from caesarean section.
14 (41%) mothers had gestational diabetes, 5 (14%) had hypertension. The other 17 (50%) presented with any other obstetric risk.

Conclusions : To the best of the authors’ knowledge, this is the first report of ophthalmological findings in Brazilian newborns of high risk pregnancies. The prevalence of RH was higher than India and China.
This study had a higher grade RH compared to other studies, 15 (78%) of all RH were Grade III.
In conclusion more studies are needed to better understand these findings. With a greater number of patients, important risk factors related to the retinal haemorrhages in Brazil could be pointed.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Fig 1. Retinal Haemorrhages Grade III

Fig 1. Retinal Haemorrhages Grade III

 

Fig 2. Engorgement and tortuosity of inferior veins with RH.

Fig 2. Engorgement and tortuosity of inferior veins with RH.

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