Retinal haemorrhage

Retinal hemorrhage
Specialty Ophthalmology Edit this on Wikidata

Retinal hemorrhage is a disorder of the eye in which bleeding occurs in the retina, the light sensitive tissue, located on the back wall of the eye. [1] There are photoreceptor cells in the retina called, rods and cones, they can transduce light energy into nerve signals that can be processed by the brain to form visual images. [2] Retinal hemorrhage not only can affect adults, but newborn babies and infants may also suffer from this disorder.

A retinal hemorrhage can be caused by several medical conditions such as hypertension, retinal vein occlusion (a blockage of a retinal vein), anemia, leukemia or diabetes mellitus (which causes small fragile blood vessels to form, which are easily damaged).

Retinal hemorrhages that take place outside the macula can go undetected for many years, and may sometimes only be picked up when the eye is examined in detail by ophthalmoscopy, fundus photography, or a dilated fundus exam. However, some retinal hemorrhages can cause severe impairment of vision. They may occur in connection with posterior vitreous detachment or retinal detachment.

Signs and symptoms

At the early stage, a retinal hemorrhage may not show any symptom at all.

Some symptoms may include:

  • Seeing cobwebs in the vision
  • Seeing haze or shadows
  • Distorted vision
  • Rapid flashes of light in peripheral vision
  • Red tint to vision
  • Blurryness
  • Sudden blindness

Other symptoms may include head aches, pain at the temple.

Causes

Retinal hemorrhages commonly occur in high altitude climbers, most likely due to the effects of systemic hypoxia on the eye. Risk is correlated with the maximum altitude reached, duration of exposure to high altitude conditions, and climb rate.[3]

Retinal hemorrhages are significantly associated with abusive head traumas (AHT). The mechanism of the trauma is believed to be repeated acceleration and deceleration with or without blunt impact (shaken baby syndrome).[4] Around 85% of victims suffer from AHT will have retinal hemorrhages and it increases in severity with increasing likelihood of abuse.[5]

Diagnosis

A retinal hemorrhage is generally diagnosed by using an ophthalmoscope or fundus camera in order to examine the inside of the eye. A fluorescein angiography test may be conducted, in which a fluorescent dye is often injected into the patient's bloodstream beforehand so the administering ophthalmologist can have a more detailed view and examination on the blood vessels in the retina.[6] The fluorescent dye can have dangerous side effects: see Fluorescein

Eye examination may be done to check the eye(s) conditions, for instance to check how well the patient sees straight ahead, off to the sides and at different distances.

Blood tests may provide information about the patient's overall health and may also reveal the medical condition that may have caused retinal hemorrhage. [1]

Treatment

Retinal hemorrhages, especially mild ones not associated with chronic disease, will normally reabsorb without treatment. Laser surgery is a treatment option which uses a laser beam to seal off damaged blood vessels in the retina.[7] Anti-vascular endothelial growth factor (VEGF) drugs like Avastin and Lucentis have also been shown to repair retinal hemorrhaging in diabetic patients and patients with hemorrhages associated with new vessel growth.[8][9]

Alternative treatments may include providing necessary nutrients to strengthen and heal damaged blood vessels, through the consumption of dietary supplements such as Vitamins A,B,C and E. Also, the essential fatty acids including omega-3 from fish oil and flaxseed oil. [10]

Prevention

It is recommended to consult with opthalmologist as early as possible, particularly for people with vision problems, these includes floaters, flashes, cobwebs or spots in their vision. Preventive measures such as regular prenatal care and monitoring of infants with high risks of the disorder may be done to avoid further complications of retinal hemorrhages in infants. For retinal hemorrhages associated with hypertension, blood pressure can be controlled by having regular blood pressure check ups, frequent exercise, monitor daily food intakes and to practice a stress-free lifestyle. [6]

See also

References

  1. 1 2 "Retinal Hemorrhage - What You Need to Know". Drugs.com. Retrieved 2018-09-13.
  2. ↑ Yarfitz, S.; Hurley, J. B. (1994-05-20). "Transduction mechanisms of vertebrate and invertebrate photoreceptors". The Journal of Biological Chemistry. 269 (20): 14329–14332. ISSN 0021-9258. PMID 8182033.
  3. ↑ Bosch, Martina M.; Barthelmes, Daniel; Landau, Klara (December 2012). "High altitude retinal hemorrhages--an update". High Altitude Medicine & Biology. 13 (4): 240–244. doi:10.1089/ham.2012.1077. ISSN 1557-8682. PMID 23270439.
  4. ↑ "Retinal haemorrhage - an overview | ScienceDirect Topics". www.sciencedirect.com. Retrieved 2018-09-13.
  5. ↑ Binenbaum, Gil; Mirza-George, Naureen; Christian, Cindy W.; Forbes, Brian J. (June 2009). "Odds of abuse associated with retinal hemorrhages in children suspected of child abuse". Journal of AAPOS : The Official Publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus. 13 (3): 268–272. doi:10.1016/j.jaapos.2009.03.005. ISSN 1091-8531. PMC 2712730. PMID 19541267.
  6. 1 2 "Retinal Hemorrhage". TheFreeDictionary.com. Retrieved 2018-09-13.
  7. ↑ http://www.laretinasurgeon.com/retinal-bleeding.aspx%5Bfull+citation+needed%5D
  8. ↑ Spaide RF, Fisher YL (March 2006). "Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage". Retina. 26 (3): 275–8. doi:10.1097/00006982-200603000-00004. PMID 16508426.
  9. ↑ http://www.webmd.com/eye-health/macular-degeneration/anti-vegf-medicines-for-wet-age-related-macular-degeneration-amd%5Bfull+citation+needed%5D
  10. ↑ "Retinal Physician - Ocular Dietary Supplementation — Food For Thought". Retinal Physician. Retrieved 2018-09-13.

Further reading

  • Currie, A D M; Bentley, C. R.; Bloom, P. A. (2001). "Short report: Retinal haemorrhage and fatal stroke in an infant with fibromuscular dysplasia". Archives of Disease in Childhood. 84 (3): 263–4. doi:10.1136/adc.84.3.263. PMC 1718691. PMID 11207180.
  • Zuccoli, Giulio; Panigrahy, Ashok; Haldipur, Anshul; Willaman, Dennis; Squires, Janet; Wolford, Jennifer; Sylvester, Christin; Mitchell, Ellen; Lope, Lee Ann; Nischal, Ken K.; Berger, Rachel P. (2013). "Susceptibility weighted imaging depicts retinal hemorrhages in abusive head trauma". Neuroradiology. 55 (7): 889–93. doi:10.1007/s00234-013-1180-7. PMC 3713254. PMID 23568702.
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