Improved documentation of retinal hemorrhages using a wide-field digital ophthalmic camera in patients who experienced abusive head trauma

Arch Pediatr Adolesc Med. 2001 Oct;155(10):1149-52. doi: 10.1001/archpedi.155.10.1149.

Abstract

Objective: To describe the clinical use of a wide-field digital ophthalmic camera (RetCam 120; Massie Research Laboratories, Inc, Dublin, Calif) for the documentation of retinal hemorrhages in patients who experienced abusive head trauma.

Design: Case series.

Setting: Pediatric intensive care unit at a tertiary care center.

Participants: Children with suspected abusive head trauma.

Results: Eight children were studied during a 9-month period. The median age of the children was 2.25 months (range, 0.8-18.0 months). There were 4 male and 4 female patients. All patients had intracranial bleeding, documented by computed axial tomographic scans of the head. Of the 8 patients, 6 had bilateral retinal hemorrhages. All patients underwent a formal examination by a pediatric ophthalmologist (R.S. and others) using a wide-field digital ophthalmic camera. Three children died.

Conclusions: The wide-field digital ophthalmic camera allowed good visualization and produced high-quality photographic images, resulting in instant bedside documentation of retinal pathological features. The wide-field digital ophthalmic camera provides a new tool for the evaluation and precise documentation of retinal hemorrhages in suspected and confirmed cases of abusive head trauma.

MeSH terms

  • Child Abuse / diagnosis*
  • Craniocerebral Trauma / complications
  • Craniocerebral Trauma / diagnosis
  • Female
  • Fiber Optic Technology
  • Humans
  • Image Processing, Computer-Assisted
  • Infant
  • Infant, Newborn
  • Male
  • Photography / instrumentation*
  • Photography / methods*
  • Point-of-Care Systems
  • Retinal Hemorrhage / diagnosis*
  • Retinal Hemorrhage / etiology