眼底出血を伴う被虐待児症候群の4例

Fundus hemorrhage in four cases of battered baby syndrome

要約　目的：眼底出血がある被虐待児症候群の4症例の報告。症例：4例すべてが生後2～3か月の乳児で，2例は父親による虐待，2例は偶発性の外傷が原因であった。所見：全例に急性硬膜下血腫があり，網膜下出血が4例7眼，黄斑前出血が2例2眼，硝子体出血が2例2眼にあった。眼底出血は1～4か月で自然に吸収されたが，脳障害のために視力は不良であった。黄斑前出血がある1例には形態覚遮断弱視が発症したが，健眼遮蔽治療で視力が向上した。結論：被虐待児症候群では頭蓋内と眼底出血が併発しやすい。再発防止のため，早期診断が必要であり，継続的な観察と加療が必要である。

Abstract.　Purpose：To report four cases of shaken baby syndrome with intracranial and fundus hemorrhage. Cases：The four cases were brought to the hospital at the age of 2 to 3 months. Two had been injured by the father and two had suffered accidental trauma. Findings：All the 4 cases had acute subdural hematoma. Subretinal hemorrhage was present in 7 eyes of 4 cases,premacular hemorrhage in 2 eyes of 2 cases,and vitreous hemorrhage in 2 eyes of 2 cases. Fundus hemorrhage resolved spontaneously 1 to 4 months later. Visual acuity remained poor due to cerebral damage. One case developed form-deprivation amblyopia. Visual acuity improved after occlusion therapy to the fellow eye. Conclusion：Intracranial and fundus hemorrhage may be present in battered baby syndrome. Early diagnosis is necessary to prevent further injury. Patients need continued observation and treatment.