| Smartphone Fundus Photography in an Infant with Abusive Head Trauma. |
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Yong Hyun Kim, Shin Young Choi, Ji Sook Lee, Soo Han Yoon, Seung Ah Chung |
1Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea. mingming8@naver.com
2Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
3Department of Neurosurgery, Ajou University School of Medicine, Suwon, Korea. |
| 학대뇌손상 영아에서 스마트폰으로 촬영한 안저소견 |
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김용현1⋅최신영1⋅이지숙2⋅윤수한3⋅정승아1 |
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아주대학교 의과대학 안과학교실1, 아주대학교 의과대학 응급의학과교실2, 아주대학교 의과대학 신경외과교실3 |
Correspondence:
Seung Ah Chung,
Email: mingming8@naver.com
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Received: 24 August 2017 • Revised: 6 September 2017 • Accepted: 16 October 2017 |
| Abstract |
PURPOSE
To report fundus photography using a smartphone in an infant with abusive head trauma. CASE SUMMARY: An 8-month-old male infant presented to the emergency room with decreased consciousness and epileptic seizures that the parents attributed to a fall from a chair. He had no external wounds or fractures to the skull or elsewhere. However, computerized tomography of the brain revealed an acute subdural hematoma in the right cranial convexity and diffuse cerebral edema, leading to a midline shift to the left and effacement of the right lateral ventricle and basal cistern. The attending neurosurgeon promptly administered a decompressive craniectomy. Immediately after the emergency surgery, a fundus examination revealed numerous multi-layered retinal hemorrhages in the posterior pole extending to the periphery in each eye. He also had white retinal ridges with cherry hemorrhages in both eyes. We acquired retinal photographs using the native camera of a smartphone in video mode. The photographer held the smartphone with one hand, facing the patient's eye at 15–20 cm, and held a 20 diopter condensing lens at 5 cm from the eye in the other hand. Our documentation using a smartphone led to a diagnosis of abusive head trauma and to obtain the criminal's confession, because the findings were specific for repetitive acceleration-deceleration forces to an infant`s eye with a strong vitreoretinal attachment. CONCLUSIONS: This ophthalmic finding had a key role in the diagnosis of abusive head trauma. This case presented the diagnostic use of a smartphone for fundus photography in this important medicolegal case. |
| Key Words:
Abusive head trauma;Retinal hemorrhages;Shaken baby syndrome;Smartphone fundus photography |
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