ArticleInternational journal of legal medicine2023
Assessing retinal hemorrhages with non-invasive post-mortem fundus photographs in sudden unexpected death in infancy.
Article in International journal of legal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Post-mortem fundus examination after sudden unexpected death in infancy (SUDI): can we do better? a study based on the French SUDI registry.International journal of legal medicine · 2026Article
- From Fragile Lives to Forensic Truth: Multimodal Forensic Approaches to Pediatric Homicide and Suspect Death.Diagnostics (Basel, Switzerland) · 2025Review
- Fatal child abuse detected by systematic post-mortem fundus photograph in sudden death in infancy.International journal of legal medicine · 2024Article
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8 authors.
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Abstract
introductionIn the case of sudden unexpected death in infancy (SUDI), eye examination is systematic to detect retinal hemorrhages (RH) that are a crucial hallmark for abusive head trauma (AHT). The aim of this study is to assess the ability of non-invasive post-mortem fundus photographs (PMFP) to detect RH in case of SUDI.
methodsBicentric retrospective analysis of consecutive cases of SUDI under 2 years of age were managed by two French SUDI referral centers with PMFP by RetCam (Clarity Medical Systems USA). PMFP were reviewed randomly, twice, by three independent ophthalmologists blinded for clinical data.
resultsThirty cases (60 eyes) were included. Median age was 3.5 months (interquartile [1.6; 6.0]). No child died of AHT. Image quality was sufficient to assert presence or absence of RH in 50 eyes (83%). Sufficient quality rate was significantly higher when the post-mortem interval was inferior to 18 h (91%, 42/46) as opposed to over 18 h (57%, 8/14, p=0.0096). RH were found in six eyes (10%), four children (13%), with excellent inter and intra-raters' concordance (Cohen's Kappa from 0.81 [0.56-1.00] to 1.00 [1.00-1.00]).
conclusionPMFP can detect RH in case of SUDI and is a relevant systematic screening test to be carried out as soon as the deceased child arrives in the hospital. It can decrease the need of eye removal for pathological examination, but further studies are needed to define the best decision algorithm.
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