SEARCHSYSTEMATIC_REVIEWophthalmology, neuro-ophthalmology

systematic_review·ophthalmology, neuro-ophthalmology, pediatric ophthalmology, retina, clinical trial·PMC10217069

New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review

Diagnostics · 8 authors, 3 centres

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TL;DR

However, it also highlights limitations, such as the high observer dependence and error rate of ophthalmoscopic reports, and the challenges of applying certain techniques to awake infants.

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However, it also highlights limitations, such as the high observer dependence and error rate of ophthalmoscopic reports, and the challenges of applying certain techniques to awake infants.

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systematic_review

SPECIALTY

ophthalmology

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AI pipeline

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100% · A

ORIGINAL PAPER

PMC10217069

New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review

Diagnostics

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ABSTRACT

Abstract (1) Background: Head trauma represents the first cause of death in abused children, but diagnostic knowledge is still limited. The characteristic findings of abusive head trauma (AHT) are retinal hemorrhages (RH) and additional ocular findings, including optic nerve hemorrhages (ONH). However, etiological diagnosis must be cautious. (2) Methods: The Preferred Reporting Items for Systematic Review (PRISMA) standards were employed, and the research focus was the current gold standard in the diagnosis and timing of abusive RH. (3) Results: Sixteen articles were included for qualitative synthesis. The importance of an early instrumental ophthalmological assessment emerged in subjects with a high suspicion of AHT, with attention to the localization, laterality, and morphology of the findings. Sometimes it is possible to observe the fundus even in deceased subjects, but the current techniques of choice consist of Magnetic Resonance Imaging and Computed Tomography, also useful for the timing of the lesion, the autopsy, and the histological investigation, especially if performed with the use of immunohistochemical reactants against erythrocytes, leukocytes, and ischemic nerve cells. (4) Conclusions: The present review has made it possible to build an operational framework for the diagnosis and timing of cases of abusive retinal damage, but further research in the field is needed. Keywords: abusive head trauma, child abuse, retinal hemorrhage, optic nerve hemorrhage, shaken baby syndrome, forensic pathology, ophthalmoscopy, autopsy, immunohistochemistry, operative framework

CITATION EXPORT

Nicola Di Fazio, Giuseppe Delogu, Donato Morena et al.. New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review. Diagnostics. (2023). https://doi.org/10.3390/diagnostics13101722

AUTHORS

8 · 3 CENTRES

Nicola Di Fazio, Giuseppe Delogu, Donato Morena, Luigi Cipolloni, Matteo Scopetti, Sara Mazzilli, Paola Frati, Vittorio Fineschi

1Department of Anatomical, Histological, Forensic and Orthopaedic Science, Sapienza University of Rome, 00185 Rome, Italy; [email protected] (N.D.F.); [email protected] (G.D.); [email protected] (D.M.); [email protected] (S.M.); [email protected] (P.F.)
2Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, 71100 Foggia, Italy; [email protected]
3Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy; [email protected]