Hand-held spectral domain optical coherence tomography finding in shaken-baby syndrome.
Hand-held spectral domain optical coherence tomography finding in shaken-baby syndrome.
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DOI：
10.1097/iae.0b013e3181dc048c
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发表时间：
2010-04-01
期刊：
影响因子：
--
通讯作者：
Lee, Thomas C
中科院分区：
文献类型：
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作者：
Muni, Rajeev H;Kohly, Radha P;Lee, Thomas C
目得：本研究旨在记录摇晃婴儿综合征（SBS）的手持式光谱域光学相干断层扫描（HHSD-OCT，Bioptigen，达勒姆，NC）结果。SBS的非意外创伤与视网膜表现相关，包括视网膜各层的损伤和视网膜劈裂。方法：连续3例疑似SBS的患者接受完整的眼部检查，使用RetCam眼底照相（Clarity Medical Systems，普莱森顿，CA），并用HHSD-OCT成像。HHSD-OCT图像的采集需要助手稳定婴儿的头部。所有三名患者的临床表现与SBS一致，包括视网膜前和视网膜内血管瘤。手持光谱域光学相干断层扫描记录局灶性后玻璃体分离的五只眼睛中的四个与多层视网膜劈裂在一只眼睛，破坏的中心凹结构和中心凹脱离，内界膜或内视网膜劈裂在一只眼睛。手持光谱域光学相干断层扫描记录视网膜前病变在所有五只眼睛。结论：手持光谱域光学相干断层扫描有助于SBS患者的评价。在我们的系列中，所有患者都有临床检查未检测到的玻璃体视网膜异常，包括多层视网膜劈裂。手持式光谱域光学相干断层扫描允许SBS婴儿的玻璃体视网膜界面和视网膜的高分辨率成像，并提供了各种视网膜发现的机制的见解。
PURPOSE: 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.CONCLUSION: 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.