Association Between Neonatal Retinal Hemorrhage and Refractive Outcomes in Early Childhood

Objective: To systematically evaluate the association between neonatal retinal hemorrhage and refractive outcomes in early childhood, with a particular focus on astigmatism and astigmatic axis orientation. Methods: This study was a retrospective cohort study. 429 neonates who underwent fundus screening between September 2020 and September 2021 were retrospectively reviewed. Multivariable linear regression models were used to assess associations between neonatal retinal hemorrhage and continuous outcomes, including LogMAR visual acuity and cylinder power. Multivariable logistic regression models were applied for binary outcomes, including clinically significant astigmatism and oblique astigmatism. All models were adjusted for predefined covariates. Results: Our results demonstrated that neonatal retinal hemorrhage, whether analyzed as a binary exposure or further stratified by hemorrhage severity, was not significantly associated with childhood visual acuity, astigmatism magnitude, clinically significant astigmatism, or the risk of oblique astigmatism. Conclusion: The neonatal retinal hemorrhage was not associated with adverse visual or refractive outcomes in childhood.