Shaken-baby syndrome : Swept-source OCT findings

Author: Wassila MILI (Tunisia)

Co-authors: molka khairallah, olfa beizig, nesrine abroug, moncef khairallah

Purpose

To document the swept source optical coherence tomography (SSOCT) findings in a patient with Shaken baby syndrome (SBS).

Setting/Venue

Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir, Tunisia.

Methods

A single case report.

Results

A previously healthy 6-month-old girl was brought to the emergency department for paroxysmal crying with brief episodes of loss of consciousness. Cerebral computed tomography (CT)-scan demonstrated bilateral subdural hemorrhages. Ophthalmological examination revealed a poor pupillary response to bright light in both eyes. Fundus examination revealed bilateral preretinal and intraretinal hemorrhages involving the posterior pole and the midperiphery. There was a bilateral boat-shaped premacular hemorrhage. A diagnosis of SBS was made. Swept source OCT imaging, obtained without sedation, confirmed multilayered retinal hemorrhages in both eyes. It showed a dome-shaped detachment of the internal limiting membrane (ILM) overlying the macular hematoma bilaterally, with associated perifoveal retinal traction in the right eye. Other specific changes in the inner and outer retinal layers were noted. Six weeks later, retinal hemorrhages had substantially resolved, and there was optic disc pallor. OCT showed ILM reattachment with release of retinal traction and the development of severe diffuse retinal atrophy involving the fovea.

Conlusions

SS OCT can provide useful information in SBS, revealing a wide variety of vitreoretinal interface, inner, and outer retinal changes not detected by clinical examination. It also may have a prognostic value over follow-up.

Financial Disclosure

none

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