Peripheral retinal hemorrhages: a literature review and report on thirty-three patients.

Background: Peripheral retinal hemorrhages are often asymptomatic and are detected during routine dilation. The incidence of peripheral retinal hemorrhages is unknown and there is a paucity of information on the subject available in the literature.
Methods: This article reports on 33 patients with peripheral retinal hemorrhage detected during routine fundus examination. The possible etiologies and pathophysiology of peripheral retinal hemorrhages are discussed and a management plan for the primary care clinician is presented. The ophthalmic literature was reviewed and reports of peripheral retinal hemorrhages were included. For each etiology, the ocular and systemic sequelae, symptoms, testing, treatment, and followup are delineated.
Results: Various proposed etiologies of peripheral retinal hemorrhages include senescence, systemic and retinal vascular disease, hematologic disorders, infectious disease, hypoxia, and mechanical and iatrogenic causes.
Conclusion: Despite their asymptomatic nature, peripheral retinal hemorrhages have a variety of potential etiologies and risk factors. Causes associated with serious ocular or systemic complications must be identified so that appropriate treatment and followup can be instituted.