Prevalence of retinal hemorrhages in infants after extracorporeal membrane oxygenation

PURPOSE: To determine the prevalence of vision-threatening retinal hemorrhages in infants after venoarterial extracorporeal membrane oxygenation, and possible correlation between retinal hemorrhages and brain hemorrhages, thrombocytopenia, carotid reanastomosis, or death after extracorporeal membrane oxygenation. METHODS: We reviewed the findings of dilated ophthalmoscopic examinations performed on 37 children an average of 16 days after extracorporeal membrane oxygenation (35 neonates and two 1- year-old children). RESULTS: Five (13%) of the 37 children examined had small (≤ 1 disk diameter) intraretinal hemorrhages. Presence or absence of retinal hemorrhages did not correlate with presence of cerebral hemorrhage, mean platelet count during extracorporeal membrane oxygenation, a history of reanastomosis of the carotid artery, or subsequent death. CONCLUSION: Retinal hemorrhages observed after extracorporeal membrane oxygenation are not necessarily caused by extracorporeal membrane oxygenation; some hemorrhages may be benign and related to parturition. Children who undergo venoarterial extracorporeal membrane oxygenation are at low risk for vision- threatening retinal hemorrhage.