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Hana Azman - One of the best experts on this subject based on the ideXlab platform.

Amy W Penn - One of the best experts on this subject based on the ideXlab platform.

Steven M Greenberg - One of the best experts on this subject based on the ideXlab platform.

Nancy Beam - One of the best experts on this subject based on the ideXlab platform.

Brian J Forbes - One of the best experts on this subject based on the ideXlab platform.

  • the eye in child abuse key points on retinal Hemorrhages and abusive head trauma
    Pediatric Radiology, 2014
    Co-Authors: Gil Binenbaum, Brian J Forbes
    Abstract:

    This review presents an up-to-date overview of ocular injuries resulting from child abuse, with a spotlight on abusive head trauma. Retinal hemorrhage is a principle finding of inflicted head trauma. The specific pattern of Hemorrhages holds valuable diagnostic information, which can help to guide multidisciplinary assessments of the likelihood of abuse. Indirect ophthalmoscopy through dilated pupils by an ophthalmologist is necessary for adequate examination and documentation of retinal findings. Initial pediatrician evaluation of the eye and indications for ophthalmological consultation are reviewed. Focus is then placed upon understanding retinal hemorrhage patterns, their diagnostic significance and likely pathophysiological mechanisms. The differential diagnosis of retinal hemorrhage in young children is discussed, highlighting key distinctions among retinal hemorrhage patterns, severity and frequencies, as well as other ocular findings. The most common cause of retinal hemorrhage in an infant is trauma, and most other causes can be identified by considering the hemorrhage pattern, ocular or systemic signs and the results of laboratory and imaging tests, when indicated.

  • odds of abuse associated with retinal Hemorrhages in children suspected of child abuse
    Journal of Aapos, 2009
    Co-Authors: Cindy W Christian, Gil Binenbaum, Naureen Mirzageorge, Brian J Forbes
    Abstract:

    Purpose To describe the prevalence of retinal Hemorrhages in children being evaluated for abusive head trauma and quantify the association between the likelihood of abuse and the presence and severity of retinal Hemorrhages. Methods Retrospective cross-sectional study of 110 children aged 15 months or younger who were evaluated for abusive head trauma and received an ophthalmological examination. The child abuse specialist's diagnosis was categorized as definite accident, probable accident, probable abuse, or definite abuse, according to an algorithm that excluded eye findings. Retinal hemorrhage severity was scored on a 12-point scale (6 points per eye) based on type, size, location, and extent. Higher scores indicated greater severity of eye findings. Results Seventy-four percent of children were younger than 6 months old. Forty-five percent of cases were definite abuse and 37% were definite accident. The prevalence of retinal Hemorrhages was 32%. Across all subjects, the presence of retinal hemorrhage was highly associated with definite or probable abuse versus definite or probable accident (age-adjusted odds ratio 5.4 [95% CI, 2.1-13.6]). The odds ratio in children younger than 6 months (n = 81) was 11.7 (95% CI, 2.9-66.8). Retinal hemorrhage severity was higher in abuse versus accident ( p r = 0.406, p Conclusions Retinal Hemorrhages are highly associated with abusive head trauma, particularly in children younger than 6 months of age. Increasing retinal hemorrhage severity is correlated with increasing likelihood of abuse.