Prevalence of Retinal Hemorrhages in Perpetrator-Confessed Cases of Abusive Head Trauma | Traumatic Brain Injury | JAMA Ophthalmology | JAMA Network
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Research Letter
June 2010

Prevalence of Retinal Hemorrhages in Perpetrator-Confessed Cases of Abusive Head Trauma

Author Affiliations

Author Affiliations: Department of Ophthalmology and Visual Sciences, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada (Dr Margolin); and Departments of Pediatrics (Dr Dev), Ophthalmology (Dr Trobe), and Neurology (Dr Trobe), University of Michigan Medical Center, Ann Arbor.

Arch Ophthalmol. 2010;128(6):795. doi:10.1001/archophthalmol.2010.100

Retinal hemorrhages (RHs) are an important clinical feature in the diagnosis of abusive head trauma (AHT). Their prevalence is reported to vary widely, perhaps because they have often been used as one of the clinical criteria for a diagnosis of AHT. We conducted a retrospective study of AHT cases based on a confession of the perpetrator and without RH as a necessary qualifying criterion to establish a realistic estimate of the prevalence of RH in this condition.

Records of the Child Protection Team of the University of Michigan from 2002 to 2007 were searched to identify cases in which the perpetrator had confessed to AHT to the legal authorities investigating the case. The diagnosis of AHT was based on the perpetrator's confession plus finding 2 or more of the following: subdural hematoma, skeletal fractures (≥2) on bone survey, and clinical history suspicious for abuse. We analyzed the ophthalmologic examination notes for the prevalence of RHs.