Retinal Morphologic Features in Shaken Baby Syndrome Evaluated by Optical Coherence Tomography

Sturm, Veit; Landau, Klara; Menke, Marcel N.

doi:10.1016/j.ajo.2009.02.008

Cited by 4 publications

(7 citation statements)

References 4 publications

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“…Our SS OCT findings provide evidence of sub-ILM location of premacular hematoma similar to that previously described in Valsalva retinopathy [6]. Our results, consistent with previous data on SD-OCT, [2,3,5] show evidence of vitreoretinal interface pathology in association with multilayered hemorrhages in SBS. OCT findings may include focal posterior vitreous detachment, retinal traction, perimacular folds, retinoschisis, disinsertion of the ILM, epiretinal membrane, and macular hole.…”

Section: Discussionsupporting

confidence: 93%

“…OCT findings may include focal posterior vitreous detachment, retinal traction, perimacular folds, retinoschisis, disinsertion of the ILM, epiretinal membrane, and macular hole. These data led the theory of vitreoretinal traction due to shearing forces induced by shaking to be the most widely accepted hypothesis on the pathogenesis of retinal disease associated with SBS [2,5,7,8]. Alternatively, increased intracranial pressure due to extradural hemorrhages could be a potential mechanism of intraocular bleeding in our patient.…”

Section: Discussionmentioning

confidence: 62%

“…Thanks to the faster acquisition times of SSOCT technology, OCT scans could be obtained without sedation, although an assistant was required to hold the infant’s head. Until recently, time domain and conventional or hand-held spectral domain (SD)-OCT have been rarely used in very young children with acute SBS [ 2 – 5 ]. OCT imaging usually was performed under sedation or even general anesthesia, and OCT follow-up data were lacking in most cases.…”

Section: Discussionmentioning

confidence: 99%

“…Shaken baby syndrome (SBS), also known as abusive head trauma, refers to a constellation of clinical findings including bilateral retinal hemorrhages, subdural hemorrhage, and anoxic encephalopathy [1]. Retinal hemorrhages occur in approximately 85% of cases and they typically are numerous, multilayered and widespread, involving the posterior pole and periphery [2]. Optical coherence tomography (OCT) has been found to be useful in the evaluation of retinal hemorrhages and in the detection and characterization of associated vitreoretinal abnormalities in patients with SBS.…”

Section: Introductionmentioning

confidence: 99%

“…Optical coherence tomography (OCT) has been found to be useful in the evaluation of retinal hemorrhages and in the detection and characterization of associated vitreoretinal abnormalities in patients with SBS. However, there are only very few reports on the use of SD-OCT, and data on the newly-introduced swept-source (SS) OCT are lacking [ 2 – 5 ]. We herein report a case of SBS documented with SS OCT.…”

Section: Introductionmentioning

confidence: 99%

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Swept-source OCT findings in shaken baby syndrome: case report

et al. 2020

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Background Our purpose was to document the swept source optical coherence tomography (SSOCT) findings in a patient with Shaken baby syndrome (SBS). Case presentation SSOCT was obtained without sedation in a six-month-old girl with bilateral multilayered retinal hemorrhages due to SBS. It documented vitreoretinal interface abnormalities, including internal limiting membrane (ILM) detachment with retinal traction, in association with other specific changes in the inner and outer retinal layers. Six weeks later, retinal hemorrhages had substantially resolved, and there was optic disc pallor. OCT showed ILM reattachment with release of retinal traction and the development of severe diffuse retinal atrophy involving the fovea. Conclusions SS OCT can provide useful information in SBS, revealing a wide variety of vitreoretinal interface, inner, and outer retinal changes not detected by clinical examination. It also may have a prognostic value over follow-up.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Swept-source OCT findings in shaken baby syndrome: case report

et al. 2020

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Determining the Tractional Forces on Vitreoretinal Interface Using a Computer Simulation Model in Abusive Head Trauma

Suh

Song

Mozafari

et al. 2021

American Journal of Ophthalmology

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Abusive head trauma (AHT) is the leading cause of infant death and long-term morbidity from injury. The ocular consequences of AHT are controversial, and the pathophysiology of retinal research findings is still not clearly understood. It has been postulated that vitreoretinal traction plays a major role in the retinal findings. A computer simulation model was developed to evaluate the vitreoretinal traction and determine whether the distribution of forces in different layers and locations of the retina can explain the patterns of retinal hemorrhage (RH) seen in AHT.DESIGN: Computer simulation model study. METHODS: A computer simulation model of the pediatric eye was developed to evaluate preretinal, intraretinal, and subretinal stresses during repetitive shaking. This model was also used to examine the forces applied to various segments along blood vessels.RESULTS: Calculated stress values from the computer simulation ranged from 3-16 kPa at the vitreoretinal interface through a cycle of shaking. Maximal stress was observed at the periphery of the retina, corresponding to areas of multiple vessel bifurcations, followed by the posterior pole of the retina. Stress values were similar throughout all 3 layers of the retina (preretinal, intraretinal, and subretinal layers).CONCLUSIONS: Ocular manifestations from AHT revealed unique retinal characteristics. The model predicted stress patterns consistent with the diffuse retinal hemorrhages (RH) typically found in the posterior pole and around the peripheral retina in AHT. This computer model demonstrated that similar stress forces were produced in different layers of the retina, consistent with the finding that retinal hemorrhages are often found in multiple layers of the retina. These data can help explain the RH patterns commonly found in

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