Perimacular retinal folds and nonaccidental injury—Yes, No, or Maybe?

Chong, Victor

doi:10.1038/sj.eye.6702175

Cited by 4 publications

(2 citation statements)

References 8 publications

(6 reference statements)

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“…Some continue to challenge this literature and attempt to raise controversy. [127][128][129][130] Further research is indicated to answer remaining queries. Until such time, physicians should keep an open mind to and appropriately search and test for alternate explanations while appropriately weighting the strong available evidence to ensure that a child remains protected from harm.…”

Section: Discussionmentioning

confidence: 99%

Retinal Hemorrhage in Abusive Head Trauma

2010

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Retinal hemorrhage is a cardinal manifestation of abusive head trauma. Over the 30 years since the recognition of this association, multiple streams of research, including clinical, postmortem, animal, mechanical, and finite element studies, have created a robust understanding of the clinical features, diagnostic importance, differential diagnosis, and pathophysiology of this finding. The importance of describing the hemorrhages adequately is paramount in ensuring accurate and complete differential diagnosis. Challenges remain in developing models that adequately replicate the forces required to cause retinal hemorrhage in children. Although questions, such as the effect of increased intracranial pressure, hypoxia, and impact, are still raised (particularly in court), clinicians can confidently rely on a large and solid evidence base when assessing the implications of retinal hemorrhage in children with concern of possible child abuse.

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Section: Discussionmentioning

confidence: 99%

Retinal Hemorrhage in Abusive Head Trauma

2010

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“…24 -28 There is debate in the literature as to whether perimacular folds are diagnostic of retinal shaking injury and as to the causal mechanism of these folds. 25,29 Perimacular folds have been associated with increased morbidity and mortality in children with head injuries caused by abuse. 25,30 In two eyes, we found perimacular retinal folds, and in one eye, this was associated with posterior vitreous separation and attachment at the site of the white fold.…”

Section: Discussionmentioning

confidence: 99%

Imaging the Infant Retina with a Hand-held Spectral-Domain Optical Coherence Tomography Device

Scott

Farsiu

Enyedi

et al. 2009

American Journal of Ophthalmology

155

109

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• PURPOSE: To evaluate and treat infant retina through the use of a hand-held spectral-domain optical coherence tomography (SD OCT) device in selected cases of Shaken Baby syndrome (SBS).• DESIGN: Observational case series.• METHODS: A novel SD OCT system was optimized and evaluated for infant imaging. An adult eye was imaged with both a standard clinical SD OCT system and the hand-held system. Four eyes of two infants with a history of SBS were imaged with the hand-held system. One infant was imaged again during follow-up examinations. Robust image processing algorithms were developed to create high-quality images. Images were assessed for usefulness in demonstrating pertinent morphologic features.• RESULTS: The novel SD OCT unit proved effective for data acquisition and comparable with conventional chinrest SD OCT. Rapid data acquisition limited motion artifact within the B-scan, although there was slight motion between B scans. The SD OCT images provided previously unseen details with regard to the morphologic features of retinal lesions in these infant eyes. This information influenced prognosis and management.• CONCLUSIONS: As with adults, the hand-held customized SD OCT proved to be an invaluable tool in the differentiation of disease processes or injury in these eyes under study. SD OCT imaging systems may be considered a useful adjunct to RetCam fundus photography for assessment and clinical management in cases of SBS. (Am J Ophthalmol 2009;147:364 -373.

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Retinale Blutungen und venöse Stase bei einem 10 Monate alten Säugling nach Sturz?

et al. 2015

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This report describes the case of a 10-month-old infant, who was delivered to our hospital by the emergency physician intubated and in an unclear unconscious state. The father reported that the child had fallen from the couch to the ground. The consulted ophthalmologist reported venous stasis in both eyes including intraretinal and preretinal bleeding in all four quadrants, a diffuse vitreous hemorrhage in the right eye and temporal retinal wrinkling in both eyes. Based on these particular clinical findings a shaken baby syndrome was suspected. This report demonstrates the importance of recognizing and correctly interpreting the typical ophthalmological signs of physical child abuse in order to detect and prevent further mistreatment of children; moreover, the increasing importance of photographic documentation and histological work-up of the findings for forensic reasons are emphasized.

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Perimacular retinal folds and nonaccidental injury—Yes, No, or Maybe?

Cited by 4 publications

References 8 publications

Retinal Hemorrhage in Abusive Head Trauma

Retinal Hemorrhage in Abusive Head Trauma

Imaging the Infant Retina with a Hand-held Spectral-Domain Optical Coherence Tomography Device

Retinale Blutungen und venöse Stase bei einem 10 Monate alten Säugling nach Sturz?

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