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Sander R. Dubovy, Brett P. Bielory, Lisa Olmos, Audina M. Berrocal; Histopathologic Findings of Peripheral Retinal Hypoperfusion in the Shaken Baby Syndrome. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4550.
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Fluorescein angiographic findings have demonstrated peripheral retinal vascular alterations in children subjected to nonaccidental trauma1. Seven of ten eyes studied disclosed peripheral retinal nonperfusion with abnormalities in both the arterial and venous side of the retinal vascular circulation. The purpose of this study is to review autopsy cases of children who sustained nonaccidental trauma and demonstrate the histopathologic findings of the peripheral retinal circulation.
The case files of the Florida Lions Ocular Pathology Laboratory were reviewed to obtain cases of children that had sustained non accidental trauma with ocular and systemic findings. The eyes had been evaluated histopathologically and were stained for CD31 to characterize the peripheral retinal vascular system. The presence of vascular lumen formation and punctate endothelial staining was evaluated and compared with five cases of unremarkable child eyes that had been studied in the laboratory.
Nine cases (17 eyes) of children who had sustained nonaccidental trauma and lived for at least two months before expiration were identified. In all cases there was evidence of previous ocular trauma. The CD31 (endothelial) staining of the peripheral retinal vessels was diminished in comparison to the controls in regard to overall decreased lumen formation in the far retinal periphery and increased distance of termination of vascular lumen formation from the ora serrata in both the nasal and temporal retina.
The findings of peripheral retinal nonperfusion is demonstrated in autopsy specimens of children that sustained nonaccidental trauma.1Goldenberg DT, Wu D, Capone Jr A, Drenser KA, Trese MT. Nonaccidental Trauma and Peripheral Retinal Nonperfusion. Ophthalmology Vol 117(3), March 2010, pgs 561-566.
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