Hand-held spectral domain optical coherence tomography finding in shaken-baby syndrome.
OBJECTIVE
The purpose of this study was to document the hand-held spectral domain optical coherence tomography (HHSD-OCT, Bioptigen, Durham, NC) findings in shaken-baby syndrome (SBS). The nonaccidental trauma in SBS has been associated with retinal findings, including hemorrhages in all layers of the retina and retinoschisis.


METHODS
Three consecutive patients with presumed SBS underwent complete ocular examination, fundus photography with the RetCam (Clarity Medical Systems, Pleasanton, CA), and imaging with the HHSD-OCT. Acquisition of the HHSD-OCT images required an assistant to stabilize the head of the infant.


RESULTS
All three patients had clinical findings consistent with SBS, including preretinal and intraretinal hemorrhages. Hand-held spectral domain optical coherence tomography documented focal posterior vitreous separation in four of the five eyes with multilayered retinoschisis in one eye, disruption of the foveal architecture and foveolar detachment in one eye, and disinsertion of the internal limiting membrane or inner retinoschisis in one eye. Hand-held spectral domain optical coherence tomography documented preretinal hemorrhages in all five eyes.


CONCLUSIONS
Hand-held spectral domain optical coherence tomography is helpful in the evaluation of patients with SBS. All patients in our series had vitreoretinal abnormalities not detected on clinical examination, including, for example, multilayered retinoschisis. Hand-held spectral domain optical coherence tomography allows high-resolution imaging of the vitreoretinal interface and retina in infants with SBS and has provided insight into the mechanism of various retinal findings.
Muni
Rajeev H
RH
The Vision Center, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California 90027-0980, USA.
Kohly
Radha P
RP
Sohn
Elliott H
EH
Lee
Thomas C
TC
D002675:Child, Preschool; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D004569:Electroencephalography; D006801:Humans; D007223:Infant; D008297:Male; D012166:Retinal Hemorrhage / Q000175:diagnosis*; D041441:Retinoschisis / Q000175:diagnosis*; D012189:Retrospective Studies; D038642:Shaken Baby Syndrome / Q000175:diagnosis*; D041623:Tomography, Optical Coherence / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D020255:Vitreous Detachment / Q000175:diagnosis*