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Improved Documentation of Retinal Hemorrhages Using a Wide-Field Digital Ophthalmic Camera in Patients Who Experienced Abusive Head Trauma
Thomas A. Nakagawa, MD;
Ruta Skrinska, MD
Arch Pediatr Adolesc Med. 2001;155:1149-1152.
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.
From the Division of Pediatric Critical Care Medicine, Children's Hospital
of The King's Daughters (Dr Nakagawa), and the Department of Pediatrics, Eastern
Virginia Medical School (Dr Nakagawa), Norfolk, Va. Dr Skrinska is in private
practice in Norfolk.
Corresponding author and reprints: Thomas A. Nakagawa, MD, Division
of Pediatric Critical Care Medicine, Children's Hospital of The King's Daughters,
601 Children's Ln, Norfolk, VA 23507 (e-mail: NakagaTA{at}CHKD.com).
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