Ocular manifestations and prognosis of shaken baby syndrome in two Japanese children's hospitals

Abstract

Purpose: To distinguish the profiles of patients and ophthalmologic features and to describe the prognosis of shaken baby syndrome (SBS) in Japan.

Methods: Charts of child abuse cases involving retinal hemorrhage at Kanagawa Children's Medical Center and the National Center for Child Health and Development between January 1997 and December 2007 were retrospectively reviewed. The mean follow-up period was 22.2 months (range, 0-115 months).

Results: Twenty-one boys and 11 girls were identified. The mean age at the initial visit was 7.0 months (range, 4 days to 17 months). Four boys died during hospitalization. Seventeen eyes of ten patients (31%) had vitreous hemorrhage; 16 eyes of eight patients (25%) had a more favorable ocular prognosis with no apparent complications. Eight infants (25%) had been born prematurely. The mean maternal age was 29.9 years, and mothers were the primary perpetrator in 19 cases (59%).

Conclusions: The clinical features of SBS in Japan are comparable to those in the Western literature. However, we have also found some idiosyncratic features in Japanese SBS cases; the mother is more frequently the perpetrator and abusive parents are older than in the United States, possibly reflecting current trends in Japan toward later marriage.