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Electroretinographic findings in infants with the shaken baby syndrome
C D Fishman1, W B Dasher, S R Lambert
1Emory Eye Center, Emory University, Atlanta, GA 30322, USA.
Insights
Electroretinography (ERG) can aid in assessing retinal function in children with shaken baby syndrome and persistent visual impairment. However, ERG is generally not useful for the initial evaluation of shaken baby syndrome.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Forensic Medicine
Background:
- Shaken baby syndrome (SBS) is a form of abusive head trauma often associated with retinal hemorrhages.
- Assessing visual impairment in SBS is crucial for diagnosis and management.
- Electroretinography (ERG) measures retinal electrical activity and may help evaluate visual function.
Observation:
- Six children diagnosed with SBS and retinal hemorrhages underwent ERG testing.
- ERG results were compared to age-matched controls.
- Serial ERGs were recorded in three patients.
Findings:
- While most ERG responses did not differ significantly between SBS patients and controls, some showed attenuated amplitudes.
- ERG was instrumental in differentiating central nervous system (CNS) from retinal causes of vision loss in one case.
- Two of three patients showed improvement in ERG parameters over time.
Implications:
- ERG can be a valuable tool for assessing retinal function in SBS cases with ongoing visual impairment.
- ERG is less effective for the initial diagnostic work-up of SBS.
- This study highlights the role of ERG in the comprehensive evaluation of SBS-related visual dysfunction.
Purpose:
To determine if electroretinography is helpful in the work-up of children with the shaken baby syndrome.
Methods:
Six children with retinal hemorrhages and the shaken baby syndrome underwent electroretinography (ERG). The ERGs of these six children were compared with six age-matched controls using the sign-rank test.
Results:
Neither the implicit time nor the amplitude of the white scotopic ERG response was significantly different between these patients and age-matched controls. Although the amplitude of the blue scotopic and 30 Hz flicker responses were attenuated (p < 0.05), the implicit times were not significantly different from controls. Three of the patients had serial ERGs recorded. The b-wave implicit time and amplitude improved in two of these patients. The ERG was helpful in distinguishing between a CNS and a retinal cause of visual loss in one child.
Conclusions:
The ERG can be helpful in assessing retinal function in children with the shaken baby syndrome who have persistent visual impairment. In most cases, the ERG is not helpful in the initial assessment of children with the shaken baby syndrome.