Risk factors for non-accidental ocular trauma and retinal hemorrhage in children
Poster #: 080
Session/Time: A
Author:
Zachary R. Goodrich, BS
Mentor:
Eric Crouch, MD
Research Type: Clinical Research
Abstract
INTRODUCTION:
This study aimed to investigate the clinical and demographic characteristics of pediatric patients with non-accidental ocular trauma, with an emphasis on retinal hemorrhages (RH).
METHODS:
We performed a retrospective electronic medical record (EMR) review. Subjects, Participants, and/or Controls: Patients aged ≤18 years presenting to the emergency department at Children's Hospital of The King's Daughters (CHKD) from December 2015 to November 2020, with a final diagnosis of child abuse, child neglect, or child mistreatment Variables collected included age, sex, race/ethnicity, disability status, abuse/neglect noted in history, identified perpetrator, and ophthalmologic findings. Statistical analyses of demographics and histories compared the total population with those who underwent a formal ophthalmic investigation and those diagnosed with RH. Similar investigations compared those diagnosed with child abuse, neglect, and mistreatment. Differences in rates of male vs. female perpetrators were calculated when sex of the perpetrator was known. Main Outcome Measures: P-values were calculated to determine significance between the percentages of the above demographics and clinical histories of subjects between groups. A p-value ≤0.05 indicated significance.
RESULTS:
189 children were included in the study, with 44 receiving a formal ophthalmic evaluation and 34 being diagnosed with RH. The RH cohort was significantly younger (mean age 0.69 years) than the total population (mean age 4.97 years; p<0.0001). No significant differences in sex, race/ethnicity, or disability status were observed between cohorts. Abuse was explicitly documented less frequently in the RH cohort (14.7%) compared to the total population (59.3%; p<0.0001). The RH cohort also had higher rates of an unclear perpetrator (58.8%) compared to the total population (21.7%; p<0.0001). Male perpetrators were significantly more common than female perpetrators in the total population (64.1%, p=0.00079), ophthalmic cohort (81.8%, p=0.0028), and RH cohort (80.0%, p=0.020).
CONCLUSION:
Young age, unclear perpetrator identity, and no mention of abuse in the clinical history were significant risk factors for non-accidental ocular trauma and RH. In contrast, sex, race/ethnicity, and disability status were not associated with increased risk. Male perpetrators were disproportionately responsible for abuse-related ocular injuries. These findings highlight the importance of considering age and historical context when evaluating non-accidental ocular trauma in children.
This study aimed to investigate the clinical and demographic characteristics of pediatric patients with non-accidental ocular trauma, with an emphasis on retinal hemorrhages (RH).
METHODS:
We performed a retrospective electronic medical record (EMR) review. Subjects, Participants, and/or Controls: Patients aged ≤18 years presenting to the emergency department at Children's Hospital of The King's Daughters (CHKD) from December 2015 to November 2020, with a final diagnosis of child abuse, child neglect, or child mistreatment Variables collected included age, sex, race/ethnicity, disability status, abuse/neglect noted in history, identified perpetrator, and ophthalmologic findings. Statistical analyses of demographics and histories compared the total population with those who underwent a formal ophthalmic investigation and those diagnosed with RH. Similar investigations compared those diagnosed with child abuse, neglect, and mistreatment. Differences in rates of male vs. female perpetrators were calculated when sex of the perpetrator was known. Main Outcome Measures: P-values were calculated to determine significance between the percentages of the above demographics and clinical histories of subjects between groups. A p-value ≤0.05 indicated significance.
RESULTS:
189 children were included in the study, with 44 receiving a formal ophthalmic evaluation and 34 being diagnosed with RH. The RH cohort was significantly younger (mean age 0.69 years) than the total population (mean age 4.97 years; p<0.0001). No significant differences in sex, race/ethnicity, or disability status were observed between cohorts. Abuse was explicitly documented less frequently in the RH cohort (14.7%) compared to the total population (59.3%; p<0.0001). The RH cohort also had higher rates of an unclear perpetrator (58.8%) compared to the total population (21.7%; p<0.0001). Male perpetrators were significantly more common than female perpetrators in the total population (64.1%, p=0.00079), ophthalmic cohort (81.8%, p=0.0028), and RH cohort (80.0%, p=0.020).
CONCLUSION:
Young age, unclear perpetrator identity, and no mention of abuse in the clinical history were significant risk factors for non-accidental ocular trauma and RH. In contrast, sex, race/ethnicity, and disability status were not associated with increased risk. Male perpetrators were disproportionately responsible for abuse-related ocular injuries. These findings highlight the importance of considering age and historical context when evaluating non-accidental ocular trauma in children.