| Objective To describe the presentations,etiologies,treatments,and prognosis of pediatric vitreous hemorrhage.MethodsThe records of 210 children diagnosed with vitreous hemorrhage at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 2010 and September 2016 were reviewed retrospectively.age,sex,first symptom,etiologies,treatments,prognoses and complications were evaluated.The SPSS 19.0 statistical program was used to analyse the results.Results1?Children with vitreous hemorrhage admitted to our hospital were showed a steady upward trend in our hospital;Unilateral were the most common,accounting for 74.76%,while the bilateral accounted for 25.24%.The incidence of left eyes and right eyes was similar,no significant difference.The most common symptoms in children with vitreous hemorrhage were ocular screening,poor vision and clear trauma history,respectively accounting for 26.70%,17.60% and 14.30%.overall,the average age of first diagnosis was 3.06 years.children less than 1 age have the highest incidence,accounting for 57.62%,remarkable,the first three months were the highest incidence at this age,accounting for 57.03%.the rest show a sudden reduction in the prevalence of the disease,The overall sex ratio was 2.04:1 in children with vitreous hemorrhage,The incidence of male was higher than that of female in the each subgroup,and the maximum sex ratio was come up in adolescent subgroup(4.49:1),followed by Infancy subgroup(3.74:1).2?The etiology of vitreous hemorrhage in children was complex and diverse,with the highest incidence was ROP 44(21.00%),followed by trauma 40 cases(19.00%),FEVR 30(14.30%)and Schisis 16(7.60%).The etiology of each subgroup was different: the neonatal period: the highest distribution of etiology was: ROP 32(36.78%),FEVR(19.05%),and birth trauma(14.29%).In infancy,the highest distribution of etiology was ROP 32(42.86%),trauma(including Local and systemic trauma)14(16.09%),FEVR 13(14.92%).in the early stage of childhood: the highest cause of disease distribution was: Trauma(including Local and systemic trauma)11(28.95%),FEVR 5(13.16%)and RB 4(10.53%).Pre-school age: the highest distribution of etiology was: 19(61.29%),Schisis 4(12.09%)and FEVR 3(9.68%).School age:the highest cause of disease distribution was: trauma 9(40.91%),FEVR 3(13.64%),Coats 2(9.09%)?Adolescence: the highest cause of disease was Schisis 3(27.27%)and FEVR 2(18.18%).With the increase of age,the incidence of traumatic vitreous hemorrhage gradually reduced,traumatic vitreous hemorrhage have three incidence peaks,the first in 1 years(30.51%),the second in 4 years(11.86%),the last in 11 years(5.08%).Therefore,we should protect children against from trauma in this three age groups.All indirect trauma occurred in less than 1 years,the highest cause of direct ocular trauma was car accident 5(12.5%),fall and hurt oneself 5(12.5%),Firecracker injury 4(10%).Scleral laceration,cataract and retinal detachment are the most common complications of traumatic vitreous hemorrhage.Among spontaneous vitreous hemorrhage,the first three top was ROP 45(29.80%),FEVR 30(19.90%),Schisis 16(10.60%).The average age of primary spontaneous vitreous hemorrhage was ROP 1.09 years,FEVR 3.53 years,Schisis 5.62 years,while direct ocular trauma 5.63 years,birth injury 1 year and Terson syndrome 1.13 years.3?The sex ratio of traumatic vitreous hemorrhage was 2.11:1,and this ratio in spontaneous vitreous hemorrhage was 1.88:1.The ratio of unilateral and bilateral in traumatic vitreous hemorrhage was 3.21:1,this ratio in spontaneous vitreous hemorrhage was 3.42:1.The visual acuity Preoperative and postoperative in children with traumatic vitreous hemorrhage was significantly increased.The visual acuity Preoperative and postoperative was not significantly increased in children with spontaneous vitreous hemorrhage.Preoperative visual impairment of traumatic vitreous hemorrhage was less severe than that in patients with Spontaneous vitreous hemorrhage.There was no significant difference in postoperative visual acuity between traumatic vitreous hemorrhage and spontaneous vitreous hemorrhage.Vitreous surgery can obviously improve the refractive media.Retinal detachment is the most common complication for first postoperative and in the long run.ConclusionThe incidence of Vitreous hemorrhage in children were men more than women,and was higher in younger children.The etiology of vitreous hemorrhage in children is complex and diverse.Among traumatic vitreous hemorrhage,the most common cause was traffic accident,and the most common complication was scleral laceration,cataract and retinal detachment.The most common spontaneous vitreous hemorrhage was ROP,the most common first symptom in children with vitreous hemorrhage is eye screening.The visual acuity preoperative and postoperative in patients with traumatic vitreous hemorrhage was significantly increased.There was no significant difference in postoperative visual acuity between traumatic vitreous hemorrhage and spontaneous vitreous hemorrhage.Vitreous surgery can obviously improve the refractive media.Retinal detachment is the most common complication for first postoperative and in the long run. |
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