A Case of Nonaccidental Trauma With Subretinal Fluid Identified by Handheld Optical Coherence Tomography

Purpose: To describe subretinal fluid (SRF) identified using handheld optical coherence tomography (OCT) in a pediatric patient with nonaccidental trauma and document its structural resolution on follow-up imaging. Methods: A single case was retrospectively reviewed. Results: We report a pediatric case of nonaccidental trauma with retinal involvement evaluated using dilated fundus examination and handheld OCT. Fundus examination demonstrated bilateral multilayered retinal hemorrhages involving the posterior pole and extending into the periphery. OCT revealed inner retinal abnormalities, outer retinal changes including ellipsoid zone thickening, punctate hyperreflective foci, and SRF. The patient was managed conservatively. Follow-up OCT demonstrated complete structural resolution of the retinal abnormalities without intervention. Conclusions: Handheld OCT provides high-resolution, objective assessment of retinal microstructural injury and can detect subclinical findings in nonaccidental trauma, complementing fundus examination and widefield retinal imaging. To our knowledge, SRF has not been widely recognized as a distinct OCT finding in this condition. This case highlights transient SRF as a potential manifestation of retinal injury in nonaccidental trauma.