PubMed · 11535429
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A R Bhavsar, D Hardten, H D Gilbert, R L Lindstrom. 2001. Vitrectomy and membrane dissection surgery.. https://doi.org/10.1016/s0161-6420(01)00663-7
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Shaken baby syndrome is a constellation of injuries resulting from the intentional shaking type movement of a child who is usually younger than 3-years-old. This rapid acceleration-deceleration movement of the head is responsible for lesions attributed to shearing forces placed on the vitreoretinal structures and meningeal vessels across the dura. The ophthalmic findings include intraocular hemorrhages, perimacular retinal folds, and peripheral retinoschisis in the presence of intracranial injuries such as subdural hematomas without obvious external signs of head trauma. We describe a case of late development of an epiretinal membrane in a child with a history of shaken baby syndrome and propose a differential diagnosis list for epiretinal membrane formation in the pediatric age group.
Macular holes have a special position in the paradigmatic change of vitreoretinal surgery during the past 10 years. While the rationale for existence of retinal and vitreal surgery is based largely on invasive mechanical intervention in cases of large-surface epiretinal tractions, e.g., in diabetic traction amotio or detached retina with PVR, the intention of surgical treatment for macular holes is to employ a minimally invasive method, using less direct mechanical manipulation and taking into consideration physical and cell biological aspects to induce local repair processes. Whereas the classification according to Gass is still completely based on the perspective of epiretinal traction via retracted vitreal material, newer theories, relying on more subtle diagnostic examination techniques, assume a complex interaction of tractive and proliferative effects.