OCULAR FINDINGS IN NEONATES AFTER EXTRACORPOREAL MEMBRANE-OXYGENATION

Extracorporeal membrane oxygenation (ECMO) is a modified, prolonged ca rdiopulmonary bypass procedure used to treat newborns who have reversi ble cardiac or respiratory failure. The venoarterial bypass technique requires cannulation of both the right carotid artery and the internal jugular vein, and after decannulation these vessels are permanently l igated. Left-sided retinal vascular changes after ECMO have been repor ted, and were attributed to ligation of these vessels. A retrospective review of the results of ocular examinations of 86 infants who had un dergone ECMO therapy at Childrens Hospital in Los Angeles between Marc h 1987 and May, 1991 was conducted. Normal findings were noted in 73 i nfants. One in had bilateral retinal vascular tortuosity, and 12 infan ts had incidental ocular findings, but there was no evidence of left-s ided retinal hemorrhage, venous congestion, or tortuosity. Our results suggest that left-sided retinal vascular changes after ECMO do not oc cur, occur only rarely, or clear rapidly and result in no permanent re tinal damage. To unequivocally rule out the possibility that ECMO can cause transitory retinal vascular changes, we recommend further prospe ctive studies, with ocular examinations performed before, during, and after ECMO.