Alswayed Sarah K, Aldharman Sarah S, Alraddadi Jumanah S, Almuneef Maha, Aldibasi Omar, Alfreihi Shatha
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Department of Pediatrics, King Abdullah Specialized Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Saudi J Ophthalmol. 2024 Sep 20;38(3):280-285. doi: 10.4103/sjopt.sjopt_313_23. eCollection 2024 Jul-Sep.
Abusive head trauma (AHT) is a form of child physical abuse that can result in major ocular injuries. This study describes the clinical presentation and ocular manifestations of infants diagnosed with AHT in a tertiary care center in Saudi Arabia.
This is an observational, retrospective, cross-sectional study from 2015 to 2022 conducted at King Abdullah Specialized Children's Hospital (KASCH) in Riyadh, Saudi Arabia. Inclusion criteria include infants <2 years of age, diagnosed with AHT that had an eye examination as part of the evaluation.
A total of 25 (50 eyes) cases of AHT had an eye examination documented in the electronic patients' records. The majority were males 19 (76%), and <6 months of age 10 (40%). About half of the children were healthy 13 (52%), and 12 (48%) had underlying physical illness. All patients had computed tomography scans. Subdural bleeding was noted in 22 (88%), 1 (4%) had epidural, and 4 (16%) had subarachnoid bleed. External ocular signs were noted in 8 (32%) patients only, including raccoon eyes, periorbital bruises, subconjunctival hemorrhage, and nonfixating eyes. Fundus findings were bilateral in 18 (72%), unilateral in 2 (8%), and normal in 5 (20%). In those with findings, the majority of 34 (68%) eyes had multiple retinal hemorrhages, 4 (8%) had vitreous hemorrhages, 2 (4%) retinal detachments, and 1 (2%) retinoschisis.
Fundus examination is an important part of the comprehensive examination of children with suspected AHT; the majority of patients had an abnormal fundus examination with the tendency of bilateral findings.
虐待性头部外伤（AHT）是一种儿童身体虐待形式，可导致严重眼部损伤。本研究描述了沙特阿拉伯一家三级护理中心诊断为AHT的婴儿的临床表现和眼部表现。
这是一项于2015年至2022年在沙特阿拉伯利雅得的阿卜杜拉国王专科医院（KASCH）进行的观察性、回顾性横断面研究。纳入标准包括年龄小于2岁、诊断为AHT且作为评估一部分进行了眼部检查的婴儿。
共有25例（50只眼）AHT病例在电子病历中有眼部检查记录。大多数为男性，共19例（76%），年龄小于6个月的有10例（40%）。约一半儿童健康，共13例（52%），12例（48%）有潜在身体疾病。所有患者均进行了计算机断层扫描。22例（88%）发现硬膜下出血，1例（4%）有硬膜外出血，4例（16%）有蛛网膜下腔出血。仅8例（32%）患者有眼部外部体征，包括黑眼圈、眶周瘀伤、结膜下出血和眼球不固定。眼底检查结果双侧异常的有18例（72%），单侧异常的有2例（8%），正常的有5例（20%）。在有眼底检查结果的患者中，大多数34只眼（68%）有多处视网膜出血，4只眼（8%）有玻璃体积血，2只眼（4%）有视网膜脱离，1只眼（2%）有视网膜劈裂。
眼底检查是疑似AHT儿童综合检查的重要组成部分；大多数患者眼底检查异常，且有双侧异常的倾向。
