Gluten contamination of commercial oat products in the United States.

to the editor: The discussion in Images in Clinical Medicine by Hylton and Goldberg (July 8 issue)1 implies that the circumpapillary retinal ridge is pathognomonic for the shaken-baby syndrome. This belief was widely held among ophthalmologists, pediatricians, and forensic pathologists until it was recently challenged.2,3 Two studies used a process associated with evidence-based medicine to evaluate the premise that the perimacular retinal fold is diagnostic of shaken-baby syndrome. Both studies found that such a presupposition was not supported by solid scientific evidence. Since a diagnosis of shaken-baby syndrome can lead to serious consequences, doctors should be cautious when using the circumpapillary retinal ridge as the sole criterion for this diagnosis.