Retinal Pathology In NAI ✅ Flashcards
How can tangential acceleration/deceleration which an infant might be subjected to in non-accidental injury cause damage?
It can cause vascular shearing
What might vascular shearing lead to in the brain?
Subdural haemorrhage
What might vascular shearing lead to in the retina?
Multiple, multi-layer haemorrhages and retinoschisis
What is retinoschisis?
Splitting of the layers of the retina
What are multiple retinal haemorrhages characteristic of?
Non-accidental head injury
Are multiple retinal haemorrhages specific to non-accidental head injury?
No
What should be excluded when a child presents with multiple retinal haemorrhages?
Clotting and metabolic conditions, e.g. glutaric aciduria
What does the presence of retinoschisis and perimacular fold indicate?
Significant vitreous traction
What might cause significant vitreous traction?
Severe accidental or non-accidental head injury
What are the patterns of retinal injury?
- Dark, round sub-retinal haemorrhages, often with a white centre
- Dot and blot shaped intra-retinal haemorrhages
- Flame-shaped nerve fibre layer haemorrhages
- Pre-retinal (sub-hyaloid) haemorrhages
- Vitreous haemorrhage
- Retinoschisis and perimacular folds
Where do subretinal haemorrhages occur?
In the potential space between the retina and RPE
How long do subretinal haemorrhages take to resolve?
Months
How long do intra-retinal haemorrhages take to resolve?
Weeks
How long do nerve fibre layer haemorrhages take to resolve?
Days
Where do pre-retinal haemorrhages occur?
In the potential space between the posterior hyaloid (vitreous) surface and the retina
