@article{ref1,
title="Use of digital camera imaging of eye fundus for telemedicine in children suspected of abusive head injury",
journal="British journal of ophthalmology",
year="2009",
author="Saleh, Maryam and Schoenlaub, S. and Desprez, P. and Bourcier, T. and Gaucher, D. and Astruc, D. and Speeg-Schatz, C.",
volume="93",
number="4",
pages="424-428",
abstract="AIM: Pilot study of the role of RetCam imaging for telemedicine in lieu of availability of ophthalmologist examination for cases of suspected abusive head injury. DESIGN: Cross-sectional observational study. PARTICIPANTS: 21 children admitted in the paediatric units of the University Hospital of Strasbourg (France) with suspicion of abusive head trauma were included. METHODS: Children were examined by standard ophthalmoscopy. Photographs were taken using the RetCam-120 Digital Retinal Camera. Eye fundus images were stored and remotely read by an ophthalmologist. Patients also had radiographic skeletal series to look for bone fractures, and CT scan and/or MRI of the head to look for intracranial haemorrhages. MAIN OUTCOME MEASURES: The absence or presence of retinal haemorrhages was assessed by both methods. Feasability, sensitivity and specificity of the digital camera procedure were determined. RESULTS: 85.7% of the children presented cerebral bleeding, and 14 out of the 21 (66.7%) had retinal haemorrhages on ophthalmoscopy. The digital camera detected the retinal abnormalities in all cases. One false-positive case was also reported. The sensitivity of the digital camera detection method was 100% with a specificity of 85.7%. 14 patients were eventually diagnosed as suffering from abusive trauma. RetCam helped establishing the diagnosis of abuse in 92.8% of these cases. CONCLUSIONS: Digital photography compared with ophthalmoscopy has a good sensitivity and specificity in detecting retinal haemorrhages. Remote reading of RetCam-120 photographs could be a promising strategy in detecting children with abusive head trauma.<p /><p>Language: en</p>",
language="en",
issn="0007-1161",
doi="10.1136/bjo.2008.147561",
url="http://dx.doi.org/10.1136/bjo.2008.147561"
}