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

摘要: 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 have been reported as cardinal AHT. The evidence base supporting this interpretation, however, has not reviewed. Methods A systematic keyword search MEDLINE, EMBASE, Evidence-Based Medicine Reviews was conducted original studies reporting findings in Articles were graded using a checklist reviews accuracy. Results initial yielded 971 articles, which 55 relevant graded, 20 met inclusion criteria included review. overall sensitivity IOH AHT 75% their specificity 94%. Intraretinal hemorrhage at posterior pole most common finding, although extensive, bilateral, multilayered specific Optic had 72% 71%, respectively. Traumatic folds 8% 14% AHT, respectively, but other conditions. Conclusions Prospective, consecutive confirm that infants—particularly multilayered—are highly are significantly more than conditions, autopsy studies. present minority rarely seen Financial Disclosure(s) Proprietary or commercial disclosure may be found after references.