ArticleJournal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus2016
The natural history of retinal hemorrhage in pediatric head trauma.
Article in Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 69 citations in OpenAlex.
- A meta-analysis of prognostic biomarkers in neonatal retinal hemorrhage.International ophthalmology · 2022Pooled it
- Performance and Yield of Retinal Examinations in Cases of Suspected Physical Abuse Without Intracranial Injury.Pediatric emergency care · 2026Article
- Magnetic resonance imaging-based detection of retinal hemorrhages in a multicenter cohort of abusive head trauma.Pediatric radiology · 2026Article
- Ophthalmology Examinations in Children With Skull Fractures and Underlying Focal Hemorrhage.Pediatric emergency care · 2025Article
- Evaluating a novel MR imaging biomarker for retinal hemorrhage.Pediatric radiology · 2025Article
- External Validation of Deep Learning Models for Classifying Etiology of Retinal Hemorrhage Using Diverse Fundus Photography Datasets.Bioengineering (Basel, Switzerland) · 2024Article
- Accidental vs. Abusive Head Trauma in Infancy: Is Revival Shaking the Missing Link?Clinical case reports · 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
- 26 cm fall caught on video causing subdural hemorrhages and extensive retinal hemorrhages in an 8-month-old infant.Clinical case reports · 2024Article
- Deep Learning Approach for Differentiating Etiologies of Pediatric Retinal Hemorrhages: A Multicenter Study.International journal of molecular sciences · 2023Article
- Pediatric abusive head trauma: visual outcomes, evoked potentials, diffusion tensor imaging, and relationships to retinal hemorrhages.Documenta ophthalmologica. Advances in ophthalmology · 2023Article
- Development of a Deep Learning Model for Retinal Hemorrhage Detection on Head Computed Tomography in Young Children.JAMA network open · 2023Article
- The role of retinal imaging in the management of abusive head trauma cases.International journal of legal medicine · 2022Article
- Retinal and visual function in infants with non-accidental trauma and retinal hemorrhages.Documenta ophthalmologica. Advances in ophthalmology · 2020Article
- Morphological Analysis of Retinal Microvasculature to Improve Understanding of Retinal Hemorrhage Mechanics in Infants.Investigative ophthalmology & visual science · 2020Article
- Retinal haemorrhage in a child with optic neuritis and acute disseminated encephalomyelitis.BMJ case reports · 2019Article
- A comparison of pediatric ocular injuries based on intention in patients admitted with trauma.BMC ophthalmology · 2019Article
- Resolution patterns and duration of retinal haemorrhages measured by two-dimensional retinal area pixel counts from sequential retinal imaging in childhood encephalopathies: a morphometric study.BMJ open ophthalmology · 2019Article
- The "New Science" of Abusive Head Trauma.International journal on child maltreatment : research, policy and practice · 2019Article
- Consensus statement on abusive head trauma in infants and young children.Pediatric radiology · 2018Review
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundOphthalmologists are commonly asked to interpret appearance of retinal hemorrhages (RH) in children with suspected traumatic head injury. We sought to determine the natural history of RH in young children with head trauma and to identify patterns suggestive of chronicity in order to help establish timing of suspected traumatic injury.
methodsThe medical records of children <2 years of age with abusive or accidental head trauma and RH on initial fundus examination who had 1 or more follow-up examination were retrospectively reviewed. Types of RH (intraretinal, preretinal) were noted; intraretinal hemorrhage (IRH) severity was graded as mild (0-10), moderate (10-20), or severe (>20, too numerous to count [TNTC]).
resultsA total of 91 eyes of 52 children were studied. All eyes had IRH (62 eyes with TNTC). In all but one eye, IRH resolved to none or mild within 1-2 weeks. TNTC IRH did not persist beyond a few days. The longest an isolated IRH persisted was 32 days. Preretinal hemorrhage (PRH) was present in 68 eyes, persisting 5-111 days. On initial examination, 25% of eyes had only IRH, 75% both PRH and IRH; no eyes had only PRH. At 2 weeks, 3% had only IRH, 18% both, and 45% only PRH. In no eyes did RH worsen.
conclusionsIRH clears rapidly, whereas PRH may persist for many weeks. The presence of TNTC IRHs indicates that trauma occurred within a few days prior to examination, whereas the presence of PRH with no or few IRHs suggests days to weeks since trauma. To accurately identify these patterns, eye examinations should be completed as soon as possible after admission, preferably within 24-48 hours.
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