May 2005
Volume 46, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2005
Correlation of Ocular and Systemic Findings and Manner of Death in Forensic Pediatric Autopsies: A 13 Year Experience
Author Affiliations & Notes
  • H.H. Brown
    Pathology/Ophthalmology, Pathology,
    Jones Eye Inst Univ of AR for Med Sci, Little Rock, AR
  • O.L. Middleton
    Pathology/Ophthalmology, Pathology,
    Univ of AR for Med Sci, Little Rock, AR
  • T.H. Moseley
    Ophthalmology, College of Medicine,
    Jones Eye Inst Univ of AR for Med Sci, Little Rock, AR
  • J.D. Casciano
    Ophthalmology, College of Medicine,
    Univ of AR for Med Sci, Little Rock, AR
  • W.Q. Sturner
    Pathology, AR State Crime Lab, Little Rock, AR
  • Footnotes
    Commercial Relationships  H.H. Brown, None; O.L. Middleton, None; T.H. Moseley, None; J.D. Casciano, None; W.Q. Sturner, None.
  • Footnotes
    Support  Research to Prevent Blindness (unrestricted grant)
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 3368. doi:
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      H.H. Brown, O.L. Middleton, T.H. Moseley, J.D. Casciano, W.Q. Sturner; Correlation of Ocular and Systemic Findings and Manner of Death in Forensic Pediatric Autopsies: A 13 Year Experience . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3368.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To correlate the ocular and systemic findings in forensic pediatric autopsies, with particular emphasis on the relationship(s) between intraocular and intracranial findings, and the classification of manner of death in these cases. Methods: Gross and microscopic examinations of 90 forensic pediatric autopsy cases from 1991 to 2004 were performed. Postmortem ocular examinations were performed by an experienced ophthalmic pathologist without knowledge of systemic autopsy findings. Ocular and systemic findings were subsequently correlated and tabulated. Statistical analysis when possible was performed by Fisher exact test or Chi square test. Results: Retinal hemorrhages were present in 53 of 90 (59%) cases, including 42 of 59 (71%) cases ruled as homicides, 3 of 10 (30%) natural deaths, 1 of 4 (25%) accidental deaths, and 7 of 17 (41%) cases where manner of death was undetermined (p<0.025). Retinal hemorrhages were highly correlated with intracranial meningeal hemorrhages (either subdural or subarachnoid, 49 of 90 (54%) cases: p<0.0001), but was only statistically significant for those cases deemed homicides (p<0.0001). Circular macular folds were present in 18 of 90 (20%) autopsy cases, and approached but did not reach statistical significance in cases ruled as homicides (16 of 59 (27%) cases: p=0.084) and in undetermined cases (2 of 17 (12%) cases: p=0.074). Conclusions: Retinal hemorrhages are common occurrences in the forensic pediatric autopsy population, and are highly correlated with intracranial meningeal hemorrhages. There is a statistically highly significant relationship between retinal hemorrhages and classification of manner of death as homicide. Association between circular macular folds and classification of manner of death as homicide approached but did not reach statistical significance in this series of cases.

Keywords: retina • macula/fovea • trauma 
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