Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus · 2026
Retinal hemorrhages in children with traumatic intracranial pathology in a tertiary care center.
СтатьяНазвание и аннотация: Перевод в очереди
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Srinivas Rachelle, Dairo Kolapo, Jordan Catherine O, Rogers David L, McGregor Mary Lou, Letson Megan M, Shaikhouni Ammar, Inger Hilliary E
Аннотация
BACKGROUND: Retinal hemorrhages (RH) are commonly seen with abusive head trauma (AHT). This study evaluates pediatric patients who had neuroimaging and an ophthalmologic examination in an attempt to correlate the etiology of presentation with the presence and pattern of RH and intracranial pathology.
METHODS: A retrospective review was performed on hospitalized patients under 5 years of age who underwent neuroimaging and ocular examination. The presence of intracranial pathology, RH, and diagnoses of AHT versus accidental trauma were recorded. Fundus photographs were evaluated with a published scale for RH grading.
RESULTS: Seventy-six patients were categorized as AHT, 79% of whom had acute intracranial hemorrhage (ICH). Fifty-eight percent had RH with acute ICH. Thirty-three patients were categorized as accidental trauma. None of the accidental trauma patients had RH, but 76% had acute ICH. Sixty-five percent of AHT patients had RH, with 57% of these categorized as grade 2Bii or worse. There was a significant difference when comparing the occurrence of acute ICH with RH among AHT patients (n = 44) versus accidental trauma patients (n = 0/33 [P < 0.001]). There were more accidental trauma patients with acute ICH and without RH (n = 25/33) versus AHT patients with acute ICH and without RH (n = 16/76 [P < 0.001]).
CONCLUSIONS: Among children who underwent both neuroimaging and eye examination, the majority of RH were in AHT patients. In all groups, there were numerous cases of intracranial pathology without RH, suggesting that intracranial pathology alone does not typically cause RH. Using a published scale for RH grade, our results support including AHT in the differential diagnosis when RH are seen in children under 5 years of age with signs of trauma.
METHODS: A retrospective review was performed on hospitalized patients under 5 years of age who underwent neuroimaging and ocular examination. The presence of intracranial pathology, RH, and diagnoses of AHT versus accidental trauma were recorded. Fundus photographs were evaluated with a published scale for RH grading.
RESULTS: Seventy-six patients were categorized as AHT, 79% of whom had acute intracranial hemorrhage (ICH). Fifty-eight percent had RH with acute ICH. Thirty-three patients were categorized as accidental trauma. None of the accidental trauma patients had RH, but 76% had acute ICH. Sixty-five percent of AHT patients had RH, with 57% of these categorized as grade 2Bii or worse. There was a significant difference when comparing the occurrence of acute ICH with RH among AHT patients (n = 44) versus accidental trauma patients (n = 0/33 [P < 0.001]). There were more accidental trauma patients with acute ICH and without RH (n = 25/33) versus AHT patients with acute ICH and without RH (n = 16/76 [P < 0.001]).
CONCLUSIONS: Among children who underwent both neuroimaging and eye examination, the majority of RH were in AHT patients. In all groups, there were numerous cases of intracranial pathology without RH, suggesting that intracranial pathology alone does not typically cause RH. Using a published scale for RH grade, our results support including AHT in the differential diagnosis when RH are seen in children under 5 years of age with signs of trauma.