Abstract
Retinal haemorrhages are an important component of the clinical effects of non-accidental head injuries which have significant visual morbidity. Their importance extends into the legal investigations of carers of children with subdural haemorrhages and encephalopathy who are suspected of having been non-accidentally injured. The vital precision in diagnosis relies not just on the presence of retinal haemorrhages but on the severity, extent, bilaterality and their location in the retina. Inadequate documentation of ophthalmological clinical findings and too short a follow-up to allow proper assessment of severity each give rise to difficulties for both expert witnesses and the courts.
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References
Bechtel K, Stoessel K, Leventhal JM, Ogle E, Teague B, Lavietes S, Banyas B, Allen K, Dziura J, Duncan C (2004) Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics 114:165–168
Bhardwaj G, Chowdhury V, Jacobs MB, Moran KT, Martin FJ, Coroneo MT (2010) A systematic review of the diagnostic accuracy of ocular signs in pediatric abusive head trauma. Ophthalmology 117:983–992
Bhatnagar A, Wilkinson LB, Tyagi AK, Willshaw HE (2009) Subinternal limiting membrane hemorrhage with perimacular fold in leukemia. Arch Ophthalmol 127:1548–1550
Coats B, Binenbaum G, Peiffer RL, Forbes BJ, Margulies SS (2010) Ocular hemorrhages in neonatal porcine eyes from single, rapid rotational events. Invest Ophthalmol Vis Sci 51:4792–4797
Maguire S, Pickerd N, Farewell D, Mann M, Tempest V, Kemp AM (2009) Which clinical features distinguish inflicted from non-inflicted brain injury? A systematic review. Arch Dis Child 94:860–867
Mulvihill AO, Jones P, Tandon A, Fleck BW, Minns RA (2011) An inter-observer and intra-observer study of a classification of RetCam images of retinal haemorrhages in children. Br J Ophthalmol 95:99–104
Muni RH, Kohly RP, Sohn EH, Lee TC (2010) Hand-held spectral domain optical coherence tomography findings in shaken-baby syndrome. Retina 30:S45–S50
Pierre-Kahn V, Roche O, Dureau P, Uteza Y, Renier D, Pierre-Kahn A, Dufier J-L (2003) Ophthalmologic findings in suspected child abuse victims with subdural hematomas. Ophthalmology 110:1718–1723
R v Butler (2010) EWCA Crim1269 CAs Number 2009/1668/C5
R v Harris and others (2005) EWCA crim 1980
Shaw AD, Watts P, Maguire S, Holden S, Mann M, Kemp A (2010) Are retinal findings in abused children different from those who suffer accidental head trauma? Results of a systematic review. JAAPOS 14(1):e27
Sturm V, Landau K, Menke MN (2008) Optical coherence tomography findings in shaken baby syndrome. Am J Ophthalmol 146:363–368
Vinchon M, Defoort-Dhellemmes S, Desurmont M, Dhellemmes P (2005) Accidental and nonaccidental head injuries in infants: a prospective study. J Neurosurg 102(suppl):380–384
Watts P, Obi E (2008) Retinal folds and retinoschisis in accidental and non-accidental head injury. Eye 22:1514–1516
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D. Taylor has undertaken expert witness work for NAHI-related legal cases in the United Kingdom.
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Taylor, D.S.I. Educational paper. Eur J Pediatr 171, 1007–1009 (2012). https://doi.org/10.1007/s00431-011-1579-2
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DOI: https://doi.org/10.1007/s00431-011-1579-2