Abstract
Background and Aim Perinatal HI (hypoxia–ischemia)-related visual defects including blindness are known
to be associated with ischemic lesions in intracerebral visual pathways and ischemic
retinal damage (IRD). Intraocular hemorrhages (IOH) such as retinal hemorrhage (RH),
which may result from perinatal HI, can cause IRD by various mechanisms. We aimed
to evaluate the early retinal findings in neonates with moderate-to-severe neonatal
encephalopathy (NE) who underwent TH and its relationship between coagulation status,
amplitude-integrated electroencephalography (aEEG) patterns, and magnetic resonance
imaging–magnetic resonance spectroscopy (MRI–MRS) findings.
Method and Patients A total of 31 newborn infants who underwent moderate-to-severe NE and TH included
in the study. Coagulation parameters were taken immediately before starting TH, and
daily during TH period. aEEG records were obtained during TH and rewarming period.
Binocular indirect ophthalmoscopic examination (BIOE) and MRI–MRS scanning were performed
when TH protocol completed.
Results Total 13 (41.9%) patients had abnormal BIOE findings. Ten of them were (77%) IOH,
other findings are as follows: RH (n = 7), optic disc hemorrhage (n = 2), and vitreous hemorrhage (n = 1). Initial coagulation status was not related to IOH. Worsened aEEG and MRI–MRS
results were not related to BIOE findings.
Conclusion Frequency of IOH is high in newborns with NE who underwent TH being independent from
severity of MRS–MRI findings, aEEG pattern, and disturbed coagulation status.
Keywords
hypothermia - perinatal hypoxia–ischemia - newborn - retinal hemorrhage
