Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Semin Ophthalmol. 2021 May 19;36(4):205-209. doi: 10.1080/08820538.2021.1890150. Epub 2021 Apr 1.
Ocular findings such as retinal hemorrhages are common in abusive head trauma (AHT). Binocular indirect ophthalmoscopy has been the standard for assessing the eyes of children who are victims of AHT. However, technological advances have changed our understanding of retinal findings in AHT. Literature review on AHT - retinal findings, imaging technologies, models of representation, and telemedicine applications. Many studies suggest vitreoretinal traction from repetitive acceleration-deceleration shearing forces during shaking plays an important role in the development of retinal findings in AHT. This is further supported by different imaging modalities [optical coherence tomography (OCT); magnetic resonance imaging (MRI); fluorescein angiography (FA)] and models of representation (animal and mechanical models; finite element analysis). Emerging technologies have augmented our diagnostic abilities, enhanced our understanding regarding the pathophysiology of retinal findings, and strengthened the link between vitreoretinal traction and ocular pathology in AHT. Telemedicine is also starting to play an important role in AHT.
眼部表现,如视网膜出血,在虐待性头部外伤(AHT)中很常见。双眼间接检眼镜一直是评估 AHT 受害儿童眼睛的标准方法。然而,技术进步改变了我们对 AHT 视网膜病变的认识。AHT-视网膜病变、成像技术、表现模型和远程医疗应用的文献综述。许多研究表明,在摇晃过程中反复的加速-减速剪切力引起的玻璃体视网膜牵引在 AHT 视网膜病变的发展中起着重要作用。这一点得到了不同的成像方式[光学相干断层扫描(OCT);磁共振成像(MRI);荧光素血管造影(FA)]和表现模型(动物和机械模型;有限元分析)的支持。新兴技术提高了我们的诊断能力,加深了我们对视网膜病变病理生理学的理解,并加强了 AHT 中玻璃体视网膜牵引与眼部病变之间的联系。远程医疗也开始在 AHT 中发挥重要作用。