Retinal hemorrhage: Difference between revisions
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*Due to retinal capillary rupture, can be due to acute or chronic processes | *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]] | *Subacute bacterial [[endocarditis]] | ||
*[[Hypertension|Hypertensive]] retinopathy | *[[Hypertension|Hypertensive]] retinopathy | ||
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*[[Pentoxifylline]] | *[[Pentoxifylline]] | ||
*Ocular decompression following trabeculectomy | *Ocular decompression following trabeculectomy | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:Roth spots.png|thumb|Roth spots due to retinal vein occlusion]] | [[File:Roth spots.png|thumb|Roth spots due to retinal vein occlusion]] | ||
*'''Roth Spots''': retinal hemorrhages with white center, seen on [[fundoscopy]] | *'''Roth Spots''': retinal hemorrhages with white center, seen on [[fundoscopy]] | ||
*May be asymptomatic, or cause visual loss | *May be asymptomatic, or cause [[vision loss|visual loss]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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