SynthesisEye (London, England)2013
Retinal haemorrhages and related findings in abusive and non-abusive head trauma: a systematic review.
Synthesis in Eye (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
59 citing papers in PubMed, 6 syntheses or guidelines pooled it, 183 citations in OpenAlex.
- Abusive head trauma in children under 2 years of age in Latin America: a systematic review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Pooled it
- Identifying Risk Factors of Children Who Suffered Physical Abuse: A Systematic Review.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Pooled it
- Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis.Archives of disease in childhood · 2021Pooled it
- Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking.Acta paediatrica (Oslo, Norway : 1992) · 2018Pooled it
- Characteristics of non-vitreoretinal ocular injury in child maltreatment: a systematic review.Eye (London, England) · 2017Pooled it
- Subdural hematomas: glutaric aciduria type 1 or abusive head trauma? A systematic review.Forensic science, medicine, and pathology · 2015Pooled it
- Clinical characteristics, neurosurgical management, and outcomes of pediatric abusive head trauma: a 30-year single-center study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Sentinel injuries in child abuse: a multidisciplinary approach.International journal of legal medicine · 2026Article
- Traumatic brain injury in children and adolescents: a retrospective analysis of age- and mechanism-specific injury patterns.International journal of legal medicine · 2026Article
- A Child With Abnormal Ocular Ultrasound After Out-of-Hospital Cardiac Arrest.Journal of the American College of Emergency Physicians open · 2026Review
- Spread of "triad diagnostics" in suspected Shaken Baby Syndrome.Forensic science international. Synergy · 2026Article
- Macular Hemorrhage as the First Manifestation of Leukemia.Diagnostics (Basel, Switzerland) · 2026Article
- High-altitude retinopathy - a potential model for retinal haemorrhages in suspected shaken baby syndrome.Eye (London, England) · 2025Article
- Comment on 26 cm Fall Caught on Video Causing Subdural Hemorrhages and Extensive Retinal Hemorrhages in an 8-Month-Old Infant.Clinical case reports · 2024Article
- An Update to Biomechanical and Biochemical Principles of Retinal Injury in Child Abuse.Children (Basel, Switzerland) · 2024Review
- Childhood maltreatment and health in the UK Biobank: triangulation of outcome-wide and polygenic risk score analyses.BMC medicine · 2024Article
- A retrospective study of ophthalmologic presentation, management, and outcomes in pediatric patients admitted with abusive head trauma.Frontiers in medicine · 2024Article
- Review
- Clinical and Forensic Investigation Protocols for Diagnosing Abusive Head Trauma: A Literature Review.Diagnostics (Basel, Switzerland) · 2023Review
- New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo report the retinal signs that distinguish abusive head trauma (AHT) from non-abusive head trauma (nAHT).
methodsA systematic review of literature, 1950-2009, was conducted with standardised critical appraisal. Inclusion criteria were a strict confirmation of the aetiology, children aged <11 years and details of an examination conducted by an ophthalmologist. Post mortem data, organic disease of eye, and inadequate examinations were excluded. A multivariate logistic regression analysis was conducted to determine odds ratios (OR) and probabilities for AHT.
resultsOf the 62 included studies, 13 provided prevalence data (998 children, 504 AHT). Overall, retinal haemorrhages (RH) were found in 78% of AHT vs 5% of nAHT. In a child with head trauma and RH, the OR that this is AHT is 14.7 (95% confidence intervals 6.39, 33.62) and the probability of abuse is 91%. Where recorded, RH were bilateral in 83% of AHT compared with 8.3% in nAHT. RH were numerous in AHT, and few in nAHT located in the posterior pole, with only 10% extending to periphery. True prevalence of additional features, for example, retinal folds, could not be determined.
conclusionsOur systematic review confirms that although certain patterns of RH were far commoner in AHT, namely large numbers of RH in both the eyes, present in all layers of the retina, and extension into the periphery, there was no retinal sign that was unique to abusive injury. RH are rare in accidental trauma and, when present, are predominantly unilateral, few in number and in the posterior pole.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.