The role of retinal imaging in the management of abusive head trauma cases

Antonio Oliva, Simone Grassi, Francesca Cazzato, Sayena Jabbehdari, Lucia Mensi, Giulia Maria Amorelli, Lorenzo Orazi, Vincenzo Arena, Domenico Lepore

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review


Background: As retinal hemorrhage (RH) is the most frequent and reliable finding of abusive head trauma (AHT), an ophthalmology consultation should be systematically required in suspected cases. Full retinal examination through pharmacologically dilated pupil can detect the type and pattern of RHs, helping to distinguish abusive from non-abusive head trauma. Methods: We performed a retrospective analysis of a case series of 6 infants (aged 0.6-10 months) with AHT who were admitted to the Emergency Department of Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome with severe intracranial hemorrhages. Children underwent full multidisciplinary assessment including dilated fundus examination, optical coherence tomography (OCT) and digital wide-field fundus photography (DWFFP – in our case RetCam). In our paper we report the clinical presentation, the ocular findings and outcome at discharge. Results: The mean age at the hospital admission was 6.28 months. In all infants, intracranial hemorrhages were found. Preretinal and intraretinal hemorrhages were detected, collecting good-quality retinal images. Conclusions: Imaging of retinal hemorrhages represents a fundamental moment of AHT diagnosis and documentation. Although RetCam is the gold standard for the acquisition of retinal images in suspected cases, OCT is extremely valuable in forensic evaluation since it can detect even small macular hemorrhages. Therefore, the combination of RetCam and OCT imaging can give relevant hints for the diagnosis of AHT, allowing to evaluate the extent, spread and morphology of RHs.
Lingua originaleEnglish
pagine (da-a)1-8
Numero di pagine8
RivistaInternational Journal of Legal Medicine
Stato di pubblicazionePubblicato - 2022


  • Abusive head trauma
  • Optical coherence tomography
  • Retinal imaging
  • Wide-field fundus photography


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