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Retinal and visual function in infants with non-accidental trauma and retinal hemorrhages
John P Kelly1,2, Kenneth Feldman3,4, Jason Wright5
1Roger H. Johnson Vision Clinic, Seattle Children's Hospital, Division of Ophthalmology, OA.5.342, Seattle, WA, 98105, USA. john.kelly@seattlechildrens.org.
Documenta Ophthalmologica. Advances in Ophthalmology
|February 14, 2020
Summary
Retinal dysfunction is common in infants with non-accidental trauma (NAT), with electroretinogram (ERG) abnormalities often present. A negative ERG waveform indicates severe vision loss, highlighting ERG
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Neuroscience
Background:
- Non-accidental trauma (NAT) can cause retinal hemorrhages in infants.
- Assessing visual function in these infants is crucial for early intervention and management.
Purpose of the Study:
- To investigate retinal function and visual outcomes in infants diagnosed with retinal hemorrhages secondary to non-accidental trauma (NAT).
Main Methods:
- Retrospective review of electroretinogram (ERG) recordings (full-field and multifocal), visual acuity (logMAR), clinical status, and neuroimaging.
- Comparison of multifocal ERGs with fundus imaging and control ERGs.
- Visual acuity assessment using Teller cards.
Main Results:
- Abnormal ERG amplitudes or latencies were observed in most infants during the acute phase.
- A significant proportion of infants exhibited reduced visual acuity at follow-up.
- A negative ERG waveform correlated with severe vision loss, while fundus appearance did not reliably predict visual outcome.
Conclusions:
- Retinal dysfunction is prevalent in infants with NAT-related retinal hemorrhages.
- Electroretinogram (ERG) findings, particularly a negative waveform, are critical indicators of visual prognosis.
- Normal fundus appearance does not exclude retinal dysfunction, emphasizing the importance of ERG testing.
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