First Author: D.Martinez SPAIN
Co Author(s): I. Yago Ugarte C. Hernandez Martinez J. Marin Sanchez
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To evaluate the distinctive features of optical coherence tomography (OCT) associated with Shaken Baby syndrome (SBS).
paediatric ophthalmology department, H.U. Virgen de la Arrixaca. Murcia, Spain.
We report a case of a female 6 month-old infant with SBS. The patient underwent serial complete ophthalmic examinations including slit-lamp biomicroscopy, dilated indirect ophthalmoscopy, contact colour fundus photography (RetCam; Clarity Medical Systems, Pleasanton, CA) and hand-held OCT (iVue; Optovue Inc., Fremont, CA). Computed tomography (CT), Magnetic Resonance (MR) and neurological examination were performed at admission and during the follow-up.
Ophthalmic examination revealed multiple retinal haemorrhages affecting all retinal layers, located in posterior pole and peripheral retina in both eyes. Funduscopy showed a cystic cavity partially filled with blood in the macula of the left eye. OCT confirmed a sub-internal limiting membrane retinoschisis cavity with hyperreflective content. During follow-up there was significant improvement of haemorrhages in both eyes son any surgical intervention was rejected.
Although the diagnosis of SBS/AHT is made based on the history and clinical examination, haemorrhagic retinoschisis lesion found in OCT seems to be a particular distinctive feature of SBS/AHT. OCT is a useful tool in the differential diagnosis of retinal haemorrhages in early infancy. It may also help in choosing the most appropriate therapeutic intervention depending on the haemorrhage location. The management of acute intraocular haemorrhage is primarily supportive. Progressive spontaneous resolution is generally seen during the follow-up. In prolonged vitreous or foveal haemorrhages, PPV may be helpful to avoid severe amblyopia.