One important cause of retinal haemorrhages (RHs) in children is abusive head trauma (AHT). Our programme of research was conducted on children admitted to hospital over a seven-year period who had RHs as part of their clinical presentation. This paper summarises important findings from previous publications. As a prerequisite, two basic studies were necessary: (i) a method of reporting the precise location of the RH in the retina; and (ii) defining a simple clinical classification of RHs based on the appearance of the retinal layer involved. Because raised intracranial pressure (RICP) is a frequent secondary brain insult following serious adult head injury, causing hypoxic-ischaemic injury with a resultant poor outcome, it was considered whether such RICP might also cause RHs in children. Detailed, state-of-the-art monitoring methods were used to investigate this relationship along with retinal imaging. Methodical documentation of the type, area and lifespan of RHs meant that it was possible to address the question of predicting AHT from RH numbers and characteristics, and to describe not only the duration of different layer haemorrhages, but also a previously unreported observation that some RHs transiently enlarge over two to three days before resolving normally.

中文翻译：

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儿童脑病中的视网膜出血：前瞻性研究计划的回顾

儿童视网膜出血 (RH) 的一个重要原因是虐待性头部外伤 (AHT)。我们的研究计划是针对在 7 年内住院的儿童进行的，这些儿童的临床表现中包含 RH。本文总结了以前出版物的重要发现。作为先决条件，需要进行两项基础研究： (i) 报告 RH 在视网膜中的精确位置的方法；(ii) 根据所涉及的视网膜层的外观定义简单的 RH 临床分类。由于颅内压升高 (RICP) 是成人严重颅脑损伤后常见的继发性脑损伤，导致缺氧缺血性损伤，结果不良，因此考虑此类 RICP 是否也可能导致儿童 RH。详细的，最先进的监测方法与视网膜成像一起用于研究这种关系。对 RH 的类型、面积和寿命的系统记录意味着可以解决从 RH 数量和特征预测 AHT 的问题，并且不仅可以描述不同层出血的持续时间，还可以描述以前未报告的观察，即某些 RH在正常解决之前，会在两到三天内暂时扩大。