Photographic assessment of retinal hemorrhages in infant head injury: the Childhood Hemorrhagic Retinopathy Study.

Background: Retinal hemorrhages (RH) in babies in the absence of severe trauma or a medical cause have been strongly associated with abusive head trauma (AHT). We examined the pattern of RH in accidental head injury and AHT objectively using widefield retinal imaging.

Methods: A total of 118 infants and children 1-36 months of age admitted with head injuries at two centers were included in this prospective, consecutive, comparative cohort study.

Grading system for retinal hemorrhages in abusive head trauma: clinical description and reliability study.

Purpose: There is currently no universally accepted grading system for describing retinal hemorrhages (RH) in abusive head trauma (AHT). The purpose of this study was to devise and evaluate a novel grading system and descriptive nomenclature for RH in AHT for clinical and research purposes.

Methods: A traumatic hemorrhagic retinopathy (THR) grading system was developed for assessing and quantitatively analyzing retinal findings in abusive head trauma.

Terson syndrome with ipsilateral severe hemorrhagic retinopathy in a 7-month-old child.

In infants with intracranial hemorrhage, the most common cause of intraocular hemorrhages is abusive head trauma. Terson syndrome is rare in infants, and the retinal findings, although not well reported in the literature, are generally limited to the posterior pole. We report a case of a 7-month-old boy who developed ipsilateral, extensive preretinal and intraretinal hemorrhage after subarachnoid hemorrhage from a ruptured intracranial aneurysm.

A systematic review of the diagnostic accuracy of ocular signs in pediatric abusive head trauma.

Topic: To review systematically the diagnostic accuracy of various ocular signs for pediatric abusive head trauma (AHT).

Clinical Relevance: Intraocular hemorrhages (IOH), perimacular retinal folds, traumatic retinoschisis and optic nerve sheath hemorrhages have been reported as cardinal signs of AHT. The evidence base supporting the accuracy of this interpretation, however, has not been systematically reviewed.