Felis ISSN 2398-2950

Retina: hemorrhage

Introduction

• Retinal hemorrhage may be a sign of (or sequel to) concurrent intraocular disease. Alternatively it may be an indication of a systemic bleeding disorder.
• Cause:
  • Systemic hypertension Hypertension.
  • Ocular trauma:
    • Blunt or penetrating.
  • Secondary to intraocular disease:
    • Uveitis Uveitis: viral, lens luxation Eye: lens luxation, retinal detachment Retina: detachment, neoplasia.
  • Thrombocytopenia:
    • Immune-mediated disease Immune-mediated thrombocytopenia.
    • Seondary to infectious disease (especially FeLV Feline leukemia virus disease, FIV Feline immunodeficiency virus disease, FIP Feline infectious peritonitis), neoplasia (especially leukemia, lymphoma, hemangiosarcoma), systemic inflammatory diseases, bone marrow disease, cardiac disease.
  • Clotting factor defects:
    • Primary:
      • Vitamin K dependent coagulopathy (Devon Rex).
      • Hemophilia A (Factor VIII deficiency Hemophilia.
      • Hemophilia B (Factor IX deficiency).
      • Other clotting factor deficiencies.
    • Secondary due to liver disease, rodenticide poisoning, drug toxicity, neoplasia, disseminated intravascular coagulation. 
  • Others:
    • Vasculitis, hypervicosity, chronic anemia.
• Signs: intra-retinal, subretinal or pre-retinal hemorrhage.
• Diagnosis: ophthalmoscopy.
• Treatment: treat underlying cause.

Pathogenesis

Pathophysiology

• Retinal hemorrhage may occur because of:
  • Systemic hypertension Hypertension.
  • Blunt or penetrating ocular trauma leading to traumatic hemorrhage.
  • Chorioretinal inflammation (posterior uveitis, eg secondary to infectious, immune-mediated or neoplastic causes).
  • Chronic intraocular disease such as glaucoma Glaucoma, lens luxation Eye: lens luxation, retinal detachment Retina: detachment or intraocular neoplasia, leading to development of pre-iridal fibrovascular membranes, which are associated with increased blood vessel fragility.
  • A systemic bleeding disorder such as thrombocytopenia Immune-mediated thrombocytopenia or thrombocytopathia as listed above.
  • Choroidal and retinal neoplasia (particularly metastatic tumors or lymphoma).

Diagnosis

Treatment

Outcomes