Hand-Held Spectral Domain Optical Coherence Tomography (HH-SDOCT) Findings in Children with Non-Accidental Injury (NAI)
Bhamy Hariprasad Shenoy, MBBS, MS, FICO, FRCOphth; Arun DevBorman, MD, FRCOphth; Vinod Sharma, MBBS, MS, DNB, FRCSEd, FRCOphth; Jane Ashworth, BMCh, FRCOphth, PhD;
Susmito Biswas, BSc Hons, MBBS, FRCOphth
Manchester Royal Eye Hospital
Introduction: The advent of HH-SDOCT has revolutionized pediatric retinal and optic nerve imaging. Previous studies in children with NAI have shown that HH-SDOCT helps in identifying characteristic and unique vitreoretinal abnormalities not detected on clinical examination, sometimes altering their future management. The aim of this study was to describe HH-SDOCT findings in children with NAI and evaluate their usefulness in differentiating NAI from non-NAI.
Methods: Retrospective case series of children with confirmed diagnosis of NAI and who underwent HH-SDOCT imaging. All the children underwent complete ophthalmic evaluation including RetCam fundus photography in addition to the HH-SDOCT imaging.
Results: A total of 8 children with NAI and retinal findings who underwent HH-SDOCT were included in the study. Multi-layered retinoschisis was the most common finding followed by multi-layered retinal haemorrhages and vitreous separation and traction. These findings seen on HH-SDOCT imaging were not evident on routine ophthalmological examination and RetCam imaging.
Discussion: Current study demonstrates that HH-SDOCT helps in identifying characteristic retinal findings associated with NAI which may not be evident on routine examination techniques and imaging. These findings could potentially guide the clinicians make distinction between lesions secondary to NAI from non-NAI. Current study benefits from being the largest series reported till date.
Conclusion: HH-SDOCT is a helpful tool in evaluating children with NAI. Future studies comparing HH-SDOCT findings in NAI and retinal hemorrhages due to non-NAI causes would be needed to identify the findings unique to NAI cases.
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