ArticlePediatrics2013
Patterns of retinal hemorrhage associated with increased intracranial pressure in children.
Article in Pediatrics, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 63 citations in OpenAlex.
- Ophthalmologic assessment and intracranial pressure in children: diagnostic methods, clinical correlations, and future directions.Frontiers in pediatrics · 2026Review
- External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets.Bioengineering (Basel, Switzerland) · 2024Article
- Rapid Amplification of Cerebrospinal Fluid Pressure as a Possible Mechanism for Optic Nerve Sheath Bleeding in Infants With Nonaccidental Head Injury.Investigative ophthalmology & visual science · 2024Article
- Utility of balanced steady-state field precession sequence in the evaluation of retinal and subdural hemorrhages in patients with abusive head trauma.Pediatric radiology · 2023Article
- New Insights into the Diagnosis and Age Determination of Retinal Hemorrhages from Abusive Head Trauma: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Article
- Is external hydrocephalus a possible differential diagnosis when child abuse is suspected?Acta neurochirurgica · 2022Article
- Retinal vein occlusion with cerebral infarction in a preterm neonate: a case report.BMC pediatrics · 2021Article
- Pediatric Abusive Head Trauma: A Systematic Review.Diagnostics (Basel, Switzerland) · 2021Review
- How Experiences of Child Abuse Pediatricians and Lessons Learned May Inform Health Care Providers Focused on Improving Elder Abuse Geriatrics Clinical Practice and Research.Journal of family violence · 2021Article
- Distorted Optic Nerve Portends Neurological Complications in Infants With External Hydrocephalus.Frontiers in neurology · 2021Article
- Birth-related retinal hemorrhages: The Soonchunhyang University Cheonan Hospital universal newborn eye screening (SUCH-NES) study.PloS one · 2021Article
- Pseudotumor cerebri syndrome causing a terson like syndrome.American journal of ophthalmology case reports · 2020Article
- Retinal haemorrhage in a child with optic neuritis and acute disseminated encephalomyelitis.BMJ case reports · 2019Article
- Retinal Findings in Young Children With Increased Intracranial Pressure From Nontraumatic Causes.Pediatrics · 2019Article
- Retinal and Optic Nerve Hemorrhages in the Newborn Infant: One-Year Results of the Newborn Eye Screen Test Study.Ophthalmology · 2016Article
- The eye in child abuse: key points on retinal hemorrhages and abusive head trauma.Pediatric radiology · 2014Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveRaised intracranial pressure (ICP) has been proposed as an isolated cause of retinal hemorrhages (RHs) in children with suspected traumatic head injury. We examined the incidence and patterns of RHs associated with increased ICP in children without trauma, measured by lumbar puncture (LP).
methodsChildren undergoing LP as part of their routine clinical care were studied prospectively at the Children's Hospital of Philadelphia and retrospectively at Nationwide Children's Hospital. Inclusion criteria were absence of trauma, LP opening pressure (OP) ≥ 20 cm of water (cm H2O), and a dilated fundus examination by an ophthalmologist or neuro-ophthalmologist.
resultsOne hundred children were studied (mean age: 12 years; range: 3-17 years). Mean OP was 35 cm H2O (range: 20-56 cm H2O); 68 (68%) children had OP >28 cm H2O. The most frequent etiology was idiopathic intracranial hypertension (70%). Seventy-four children had papilledema. Sixteen children had RH: 8 had superficial intraretinal peripapillary RH adjacent to a swollen optic disc, and 8 had only splinter hemorrhages directly on a swollen disc. All had significantly elevated OP (mean: 42 cm H2O).
conclusionsOnly a small proportion of children with nontraumatic elevated ICP have RHs. When present, RHs are associated with markedly elevated OP, intraretinal, and invariably located adjacent to a swollen optic disc. This peripapillary pattern is distinct from the multilayered, widespread pattern of RH in abusive head trauma. When RHs are numerous, multilayered, or not near a swollen optic disc (eg, elsewhere in the posterior pole or in the retinal periphery), increased ICP alone is unlikely to be the cause.
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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.