Resolution patterns and duration of retinal haemorrhages measured by two-dimensional retinal area pixel counts from sequential retinal imaging in childhood encephalopathies: a morphometric study. Issue 1 (24th June 2019)

• Record Type: Journal Article
• Authors: Jones, Patricia A; Minns, Robert A; Tandon, Anamika; Fleck, Brian; Mulvihill, Alan
• Is Part Of: BMJ open ophthalmology. Volume 4:Issue 1(2019)
• Publication Date: 2019-06-24
• Subjects: child health (paediatrics) -- retina -- imaging -- trauma; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1136/bmjophth-2019-000275
• Languages: English
• ISSNs: 2397-3269

Abstract

Abstract : Objective: To determine the time to resolution of different-layered retinal haemorrhages (RHs), and to describe the main patterns of their resolution in a group of children with encephalopathies. Methods and analysis: From a prospective study of 114 children with traumatic and non-traumatic encephalopathies, 429 selected individual RHs (iRHs) from 18 children were serially imaged from admission using a RetCam. Photoshop and Scion Imaging software allowed calculation of RH area in pixels. Results: Two patterns of the resolution were recognised on the basis of area measurements: a progressive decrease (pattern A, 60% of iRHs), and a form of asymmetrical decay in which iRHs first increased in size before then progressively decreasing (pattern B, 35% of iRHs). Within the pattern A group, the Kaplan-Meier median survival time (MST) (95% CI) was 10 (9.3 to 10.7) days for intra-RHs (IRHs) and 38 (10.8 to 65.2) days for pre-RHs (PRHs), log rank (Mantel-Cox) p=0.001. The mean percentage reduction in area per day was 12.5% for all iRHs, 14.5% for IRHs and 6.3% for PRHs. Conclusion: Serial area measurements of iRHs revealed that 35% haemorrhages became temporarily larger before decreasing to resolution. Serially imaged selected RHs showed a longer MST for PRHs than for IRHs.