Improved documentation of retinal hemorrhages using a wide-field digital ophthalmic camera in patients who experienced abusive head trauma.
OBJECTIVE
To describe the clinical use of a wide-field digital ophthalmic camera (RetCam 120; Massie Research Laboratories, Inc, Dublin, Calif) for the documentation of retinal hemorrhages in patients who experienced abusive head trauma.


METHODS
Case series.


METHODS
Pediatric intensive care unit at a tertiary care center.


METHODS
Children with suspected abusive head trauma.


RESULTS
Eight children were studied during a 9-month period. The median age of the children was 2.25 months (range, 0.8-18.0 months). There were 4 male and 4 female patients. All patients had intracranial bleeding, documented by computed axial tomographic scans of the head. Of the 8 patients, 6 had bilateral retinal hemorrhages. All patients underwent a formal examination by a pediatric ophthalmologist (R.S. and others) using a wide-field digital ophthalmic camera. Three children died.


CONCLUSIONS
The wide-field digital ophthalmic camera allowed good visualization and produced high-quality photographic images, resulting in instant bedside documentation of retinal pathological features. The wide-field digital ophthalmic camera provides a new tool for the evaluation and precise documentation of retinal hemorrhages in suspected and confirmed cases of abusive head trauma.
Nakagawa
T A
TA
Division of Pediatric Critical Care Medicine, Children's Hospital of The King's Daughters, 601 Children's Ln, Norfolk, VA 23507, USA. NakagaTA@CHKD.com
Skrinska
R
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D002649:Child Abuse / Q000175:diagnosis*; D006259:Craniocerebral Trauma / Q000150:complications / Q000175:diagnosis; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010781:Photography / Q000295:instrumentation* / Q000379:methods*; D019095:Point-of-Care Systems; D012166:Retinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology