Retinal hemorrhage: Difference between revisions
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==Background== | |||
*Due to retinal capillary rupture, can be due to acute or chronic processes | |||
Causes | |||
===Causes<ref>Ehlers JP, Shah CP. Wills Eye Manual, The: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 5th ed. Philadelphia, PA:Lippincott Williams & Wilkins; 2008.</ref><ref>Ling R, James B. White-centred retinal haemorrhages (Roth spots).Postgrad Med J. 1998 Oct;74(876):581-2.</ref>=== | |||
*Subacute bacterial [[endocarditis]] | |||
*[[Hypertension|Hypertensive]] retinopathy | |||
*[[Diabetes|Diabetic]] retinopathy | |||
*Trauma: [[nonaccidental trauma]] ([[shaken baby syndrome]]), [[intracranial hemorrhage]], neonatal birth trauma | |||
*[[Central Retinal Artery Occlusion (CRAO)]], [[Central Retinal Vein Occlusion (CRVO)]] | |||
*[[Anemia]], [[leukemia]], [[sickle cell anemia]] | |||
*[[Hypoxia|Anoxia]] | |||
*[[Acute mountain sickness]] | |||
*[[Carbon monoxide poisoning]] | |||
*Prolonged intubation during anesthesia | |||
*[[Connective tissue disease]], [[SLE]] | |||
*[[Scurvy]], [[Wernicke-Korsakoff syndrome]] | |||
*[[Preeclampsia]] | |||
*[[Pentoxifylline]] | |||
*Ocular decompression following trabeculectomy | |||
==Clinical Features== | |||
<ref>Ehlers JP, Shah CP. Wills Eye Manual, The: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 5th ed. Philadelphia, PA:Lippincott Williams & Wilkins; 2008.</ref><ref>Ling R, James B. White-centred retinal haemorrhages (Roth spots).Postgrad Med J. 1998 Oct;74(876):581-2.</ref> | [[File:Roth spots.png|thumb|Roth spots due to retinal vein occlusion]] | ||
*'''Roth Spots''': retinal hemorrhages with white center, seen on [[fundoscopy]] | |||
*May be asymptomatic, or cause [[vision loss|visual loss]] | |||
==Differential Diagnosis== | |||
{{Acute vision loss noninflamed DDX}} | |||
==Evaluation== | |||
*Workup dependant on clinical presentation | |||
==Management== | |||
*Treat underlying condition if appropriate | |||
==Disposition== | |||
==See Also== | |||
==External Links== | |||
==References== | |||
<references/> | |||
[[Category:Ophthalmology]] | |||
Latest revision as of 12:51, 14 May 2022
Background
- Due to retinal capillary rupture, can be due to acute or chronic processes
Causes[1][2]
- Subacute bacterial endocarditis
- Hypertensive retinopathy
- Diabetic retinopathy
- Trauma: nonaccidental trauma (shaken baby syndrome), intracranial hemorrhage, neonatal birth trauma
- Central Retinal Artery Occlusion (CRAO), Central Retinal Vein Occlusion (CRVO)
- Anemia, leukemia, sickle cell anemia
- Anoxia
- Acute mountain sickness
- Carbon monoxide poisoning
- Prolonged intubation during anesthesia
- Connective tissue disease, SLE
- Scurvy, Wernicke-Korsakoff syndrome
- Preeclampsia
- Pentoxifylline
- Ocular decompression following trabeculectomy
Clinical Features
- Roth Spots: retinal hemorrhages with white center, seen on fundoscopy
- May be asymptomatic, or cause visual loss
Differential Diagnosis
Acute Vision Loss (Noninflamed)
- Painful
- Arteritic anterior ischemic optic neuropathy
- Optic neuritis
- Temporal arteritis†
- Painless
- Amaurosis fugax
- Central retinal artery occlusion (CRAO)†
- Central retinal vein occlusion (CRVO)†
- High altitude retinopathy
- Open-angle glaucoma
- Posterior reversible encephalopathy syndrome (PRES)
- Retinal detachment†
- Stroke†
- Vitreous hemorrhage
- Traumatic optic neuropathy (although may have pain from the trauma)
†Emergent Diagnosis
Evaluation
- Workup dependant on clinical presentation
Management
- Treat underlying condition if appropriate