Vitreoretinal Traction and Perimacular Retinal Folds in the Eyes of Deliberately Traumatized Children

Massicotte, Stephen J.; Folberg, Robert; Torczynski, Elise; Gilliland, M. G. F.; Luckenbach, Martha W.

doi:10.1016/s0161-6420(91)32167-5

Cited by 114 publications

(51 citation statements)

References 9 publications

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“…These included features previously described as 'pathognomonic' of AHT, namely 'extensive RH accompanied by perimacular folds and schisis cavities found in association with intracranial haemorrhage or other evidence of trauma to the brain in an infant without another clear explanation'. 1,3,4,70 In particular, it is unclear if the absence of features, such as retinoschisis or perimacular retinal folds, in the nAHT literature reflects the absence of data or the absence of recording. However, these features were not recorded in any nAHT cases within the consecutive data sets, appearing only in isolated case reports.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 It has previously been proposed that retinal folds and haemorrhagic retinoschisis in an infant with brain injury may be diagnostic of a shaking injury. 1,3,4 Recently, however, extensive RH, retinal folds, and schisis cavities have been reported in witnessed accidental head injuries, [5][6][7] calling into question the validity of 'classic' descriptions of retinal findings in AHT.…”

Section: Introductionmentioning

confidence: 99%

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Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Maguire

Watts

Shaw

et al. 2012

Eye

160

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Aim To report the retinal signs that distinguish abusive head trauma (AHT) from non-abusive head trauma (nAHT). Methods A systematic review of literature, 1950-2009, was conducted with standardised critical appraisal. Inclusion criteria were a strict confirmation of the aetiology, children aged o11 years and details of an examination conducted by an ophthalmologist. Post mortem data, organic disease of eye, and inadequate examinations were excluded. A multivariate logistic regression analysis was conducted to determine odds ratios (OR) and probabilities for AHT. Results Of the 62 included studies, 13 provided prevalence data (998 children, 504 AHT). Overall, retinal haemorrhages (RH) were found in 78% of AHT vs 5% of nAHT. In a child with head trauma and RH, the OR that this is AHT is 14.7 (95% confidence intervals 6.39, 33.62) and the probability of abuse is 91%. Where recorded, RH were bilateral in 83% of AHT compared with 8.3% in nAHT. RH were numerous in AHT, and few in nAHT located in the posterior pole, with only 10% extending to periphery. True prevalence of additional features, for example, retinal folds, could not be determined. Conclusions Our systematic review confirms that although certain patterns of RH were far commoner in AHT, namely large numbers of RH in both the eyes, present in all layers of the retina, and extension into the periphery, there was no retinal sign that was unique to abusive injury. RH are rare in accidental trauma and, when present, are predominantly unilateral, few in number and in the posterior pole.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Maguire

Watts

Shaw

et al. 2012

Eye

160

View full text Add to dashboard Cite

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“…[23][24][25]31 Imaging eyes with SBS with SD OCT would allow the clinician to document retinal abnormalities such as traumatic macular hole, ERM, perimacular folds, and traumatic retinoschisis to provide in vivo information about vitreoretinal abnormalities in these eyes that then may be correlated with the clinical examination results and fundus findings to guide surgical planning and to determine the ultimate prognosis. In this study, we demonstrated imaging of the macula and posterior pole beyond the arcades with the hand-held SD OCT system.…”

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

156

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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“…14,16,17 However, the perimacular folds were a bit atypical for Shaken Baby syndrome in that they had a much more angulated apex, although this can occasionally be seen at autopsy from a collapsed retinoschisis cavity. 18 Another possible explanation for the findings of Lantz et al 7 may be that the child or the injury itself occurred in the presence of some unique factor that predisposed the child to the haemorrhagic retinopathy may have been present. 19 Although the child was not described as having a significant coagulopathy, perhaps the child had one or more conditions influencing coagulation such as thrombophilic factors, 19 subclinical vitamin C deficiency, 20 or a collagen disorder.…”

Section: Eyementioning

confidence: 97%

Ocular manifestations of crush head injury in children

Gnanaraj

Gilliland

Yahya

et al. 2005

Eye

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Vitreoretinal Traction and Perimacular Retinal Folds in the Eyes of Deliberately Traumatized Children

Cited by 114 publications

References 9 publications

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review

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

Ocular manifestations of crush head injury in children

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