Abstract
Abstract: :
Purpose: To evaluate unusual fundus features and fluorescein angiographic findings in infants with retinal hemorrhage as a consequence of non–accidental trauma. Methods: Retrospective review of clinical notes, photographs, and fluorescein angiograms of infants managed at a major children’s referral center over 5 years. Results: Seven patients were found on clinical examination to have peripheral retinal non–perfusion with neovascularization. This was confirmed with fluorescein angiography in two patients. Another two patients evolved to massive proliferative retinopathy and late hemorrhage leading to inoperable tractional retinal detachment in one or both eyes from 6 to 18 months after the original injury. The presence of non–perfusion did not correlate with severity of injury or extent and location of hemorrhage on presentation. Conclusions: Peripheral retinal non–perfusion can be a sequela of non–accidental trauma in the shaken baby syndrome. It should be considered in the differential diagnosis of peripheral neovascularization of children. Although the mechanism for vaso–occlusion in this condition is uncertain, infants with this type of injury should receive serial examination and possibly fluorescein angiography as they may be susceptible to late vitreous hemorrhage and complex tractional retinal detachment.
Keywords: retinal neovascularization • retinal detachment • clinical (human) or epidemiologic studies: outcomes/complications