Ophthalmological findings of extracorporeal membrane oxygenation in newborns: a case report

Extracorporeal membrane oxygenation is used in neonatology to save the lives of newborns in critical condition caused by severe respiratory and/or heart failure. Although technologies have improved and extracorporeal membrane oxygenation has become widely used, complications of the hemostatic system, including hemorrhagic and thrombotic events, remain one of the leading causes of morbidity and mortality in newborns receiving this type of therapy. This article presents a case report of ophthalmological complications in a newborn who received venoarterial extracorporeal membrane oxygenation. Within two weeks after the procedure, the patient underwent ophthalmoscopy using a pediatric wide-field retinal imaging system RetCam 3. The examination revealed signs of retinal angioapathy in the left eye. Subsequently, vascular changes worsened, from retinopathy, probably caused by thrombosis of the central retinal vein, to proliferative complications in the affected eye. Fluorescence angiography found local hyperfluorescence in the suspected occlusion area and signs of neovascularization. The patient received laser coagulation of the ischemic retinal areas to prevent retinal detachment. The patient was discharged at the age of 1.5 months, and continues to be followed-up by an ophthalmologist at our outpatient clinic.

The presented clinical case demonstrates that a retinal vascular disorder may develop in newborns after extracorporeal membrane oxygenation. That is why they require mandatory ophthalmological examination shortly after the procedure and follow-up in the catamnesis because of the risk of a sight-threatening retinal disorder.