Publication

Optical coherence tomography findings in Shaken Baby syndrome

Journal Paper/Review - Jun 11, 2008

Units
PubMed
Doi

Citation
Sturm V, Landau K, Menke M. Optical coherence tomography findings in Shaken Baby syndrome. Am J Ophthalmol 2008; 146:363-8.
Type
Journal Paper/Review (English)
Journal
Am J Ophthalmol 2008; 146
Publication Date
Jun 11, 2008
Issn Print
0002-9394
Pages
363-8
Brief description/objective

PURPOSE
To evaluate features of optical coherence tomography (OCT) associated with Shaken Baby syndrome (SBS) in an attempt to gain new insight into the pathophysiology of this phenomenon.

DESIGN
Institutional prospective observational case series.

METHODS
We report three infants with SBS. Each patient underwent an ophthalmic examination including slit-lamp biomicroscopy, dilated indirect ophthalmoscopy, color fundus photography, and OCT.

RESULTS
In all infants, numerous bilateral multilayered retinal hemorrhages were present. In one case, bilateral perimacular folds had occurred. OCT confirmed retinal hemorrhages and perimacular folds. Moreover, OCT revealed vitreoretinal traction in all infants and suspected hemorrhagic macular retinoschisis in one case. Based on OCT findings, a hypothesis of vitreoretinal traction development and retinal fold formation is proposed.

CONCLUSIONS
OCT provided valuable additional information about the ocular pathology in patients with SBS. Vitreoretinal membrane formation seen in OCT could support the pathophysiological theory of a direct mechanical effect. OCT revealed preretinal blood accumulation as a cause for localized vitreous detachment and vitreoretinal traction. Furthermore, OCT showed persistent attachment of the vitreous to the internal limiting membrane at the apices of perimacular folds and suggested small hemorrhagic macular retinoschisis in one patient. Perimacular folds and hemorrhagic macular retinoschisis are regarded as highly specific for SBS and indicate poor visual outcome. Thus OCT might be of both diagnostic and prognostic value in SBS.