Kivlin J D
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226-4812, USA.
Curr Opin Ophthalmol. 2001 Jun;12(3):158-63. doi: 10.1097/00055735-200106000-00002.
Retinal hemorrhages are the most common fundus finding in the shaken baby syndrome. They vary in type and location; no particular type is pathognomonic for the condition. Retinal hemorrhages are not needed to make a diagnosis of shaken baby syndrome. However, in a child under age 3 years, the presence of extensive bilateral retinal hemorrhages raises a very strong possibility of abuse, which must be investigated. The other possible causes for hemorrhages in this age child can be investigated and eliminated. The diagnosis of abuse should be made by someone particularly trained in this area, who can put together the entire picture of inadequate or changing history, fractures of various ages, particularly rib fractures, subdural hematoma of the brain, and retinal hemorrhages. Photographs of retinal hemorrhages are very helpful to child advocacy experts who take these cases to court.
视网膜出血是摇晃婴儿综合征中最常见的眼底表现。它们在类型和位置上各不相同；没有哪种特定类型是该病症的特征性表现。诊断摇晃婴儿综合征并不需要视网膜出血。然而，对于3岁以下的儿童，广泛双侧视网膜出血的存在极大地提示了虐待的可能性，必须对此进行调查。该年龄段儿童出血其他可能的原因也可以进行调查并排除。虐待的诊断应由在该领域接受过专门培训的人员做出，他们能够综合不充分或前后矛盾的病史、不同时期的骨折（尤其是肋骨骨折）、脑硬膜下血肿以及视网膜出血等全面情况。视网膜出血的照片对将此类案件诉诸法庭的儿童权益保护专家非常有帮助。
