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Retinal folds in the shaken baby syndrome
M W Gaynon1, K Koh, M F Marmor
1Department of Ophthalmology, Stanford University School of Medicine, California 94305.
Insights
Shaken baby syndrome can cause severe head trauma and neurological damage. Unique white retinal folds around the macula may indicate shaking injuries in child abuse cases.
Area of Science:
- Pediatric Ophthalmology
- Neurology
- Forensic Pathology
Background:
- Shaken baby syndrome, a form of abusive head trauma, presents significant diagnostic challenges.
- Understanding the ocular manifestations of abusive head trauma is crucial for timely diagnosis and intervention.
Observation:
- Two pediatric cases of presumed shaken baby syndrome were analyzed.
- Both patients exhibited severe closed head injuries with intracranial hemorrhage and elevated intracranial pressure.
- Ocular findings included extensive retinal and preretinal hemorrhages.
Findings:
- A distinctive finding was the presence of bilateral, symmetric, white ring-shaped retinal folds.
- These unique retinal folds were observed encircling the macula, outside the vascular arcades.
- The presence of these specific retinal folds is proposed as a potential diagnostic marker.
Implications:
- The identified retinal folds may serve as a key indicator of shaking injuries in child abuse.
- This finding could enhance the diagnostic capabilities in cases of suspected non-accidental trauma.
- Further research is warranted to validate these retinal folds as a reliable hallmark of abusive head trauma.
Abstract:
We examined two children with presumed shaken baby syndrome. Both children suffered severe, indirect closed head trauma with intracranial hemorrhage, sharply increased intracranial pressure, and extensive neurologic damage. In addition to extensive retinal and preretinal hemorrhages, bilateral symmetric white ring-shaped retinal folds were seen encircling the macula outside the vascular arcades. These retinal folds may be a hallmark of shaking injuries in child abuse victims.