Introduction

• Retinal hemorrhage may be a sign of (or sequel to) concurrent intraocular diseases. Alternatively it may be an indication of a systemic bleeding disorder.
• Cause:
  • Ocular trauma:
    • Blunt or penetrating.
  • Inherited ocular disease:
    • Collie Eye Anomaly (CEA Collie eye anomaly ).
    • Multifocal retinal dysplasia (MRD Retinal dysplasia ) or total retinal dysplasia (TRD Retinal dysplasia ).
  • Secondary to intraocular diseases:
    • Glaucoma Glaucoma , uveitis Uveitis , lens luxation Lens: luxation , retinal detachment Retina: detachment , neoplasia Retrobulbar: neoplasia.
  • Systemic hypertension Hypertension.
  • Thrombocytopenia Immune-mediated thrombocytopenia :
    • Decreased platelet production secondary to drugs, neoplasia, erhlichiosis Ehrlichiosis.
    • Increased platelet destruction secondary to drugs, neoplasia, viral infection, immune-mediated disease.
  • Clotting factor defects:
    • Primary due to factor deficiencies, eg von Willebrand's Von Willebrand's disease.
    • Secondary due to liver disease, rodenticide poisoning, drug toxicity, neoplasia.Angiostrongylus vasorum Angiostrongylosis , erhlichiosis, disseminated intravascular coagulation Disseminated intravascular coagulation.
  • Others:
    • Vasculitis, hyperviscosity, chronic anemia, diabetic retinopathy Diabetic retinopathy.
• Signs: intra-retinal, subretinal or pre-retinal hemorrhage.
• Diagnosis: ophthalmoscopy.
• Treatment: treat underlying cause.

Pathogenesis

Etiology

• Trauma, local (intraocular) disease or systemic disease leading to retinal hemorrhage.

Predisposing factors

• Renal disease - hyperadrenocorticism Hyperadrenocorticism , diabetes mellitus Diabetes mellitus , phaechromocytoma Pheochromocytoma predisposing to hypertension.

Specific

• Breed if inherited ocular disease.

Pathophysiology

• Retinal hemorrhage may occur because of:
  • Congenital retinal blood vessel abnormalities (such as vitreo retinal blood vessel loops in collie eye anomaly Collie eye anomaly ).
  • Blunt or penetrating ocular traum leading to traumatic hemorrhage.
  • Chorioretinal inflammation (posterior uveitis, eg secondary to infectious, immune-mediated or neoplastic causes).
  • Chronic intraocular disease such as glaucoma, lens luxation, retinal detachment or intraocular neoplasis, leading to development of pre-iridal fibrovascular membranes, which are associated with increased blood vessel fragility.
  • A systemic bleeding disorder such as thrombocytopenia or thrombocytopathia as listed above .
  • Systemic hypertension  Hypertension.
  • Choroidal and retinal neoplasia (particularly metastatic tumors).
• Diabetes mellitus leading to diabetic retinopathy  Diabetic retinopathy.

Diagnosis

Treatment

Outcomes