Pathologic observations were found to be statistically more frequent with abusive head

trauma (cases) than with alternative cause (controls). For each finding in the abusive head trauma group, the percent prevalence, odds ratio between cases and controls, and the corresponding 95% odds ratio confidence interval were as follows: subdural hemorrhage in the optic nerve ZD1839 sheath, 97%, 1305, 114.7–14 851.0; intrascleral hemorrhage, 63%, 79.5, 10.2–616.9; any retinal hemorrhage, 83%, 33.3, 11.2–99.6; hemorrhage extending to the ora, 70%, 107.3, 13.7–839.4; cherry hemorrhage, 40%, 30.7, 4.0–237.6; perimacular ridge, 42%, 15.7, 3.5–70.9; and ILM tear, 85%, 46.5, 14.5–149.4. The odds ratio for cherry hemorrhage, hemorrhage extending to ora, and intrascleral hemorrhage required substituting 1 for 0 in order to avoid indeterminate calculations for control eyes that lacked each of these 3 associated findings, thereby making the corresponding odds ratio estimations conservative. Perimacular ridges were found in only 2 control eyes, both from the same case: a 16-month-old male infant, who was feeding koi fish in a pond with family nearby, drowned and perished despite shaking resuscitative efforts upon rescue from the pond. The Table shows pathologic observations of the abusive head trauma group organized relative to laterality, sex, and age. Pathologic findings were more commonly

buy Veliparib seen bilaterally than unilaterally for every observation. Each one had similar or greater frequency in younger infants. Specifically, subdural hemorrhage (2-tailed, unpaired, independent t tests, P = .030), any retinal hemorrhage (P = .048), hemorrhage extending to the ora serrata (P = .024), ILM tear (P = .002), and formation of the perimacular ridge (P = .044) were all significantly more frequent in infant eyes younger than 16 months. There was no significant difference regarding age in findings of intrascleral hemorrhage (P = .306) or cherry

hemorrhage (P = .334). No significant difference with respect to sex was found (P > .05). The alternative cause group demonstrated zero to few positive findings for each category ( Table). All 60 abusive head trauma eyes had at least Mannose-binding protein-associated serine protease 1 histopathologic finding from the retinal hemorrhages, ocular hemorrhages, or vitreoretinal interface pathology groups, as illustrated in set (Venn) diagrams showing overlapping relationships (Figure 1). Fifty eyes (83%) had retinal hemorrhages, while 10 (17%) did not have a retinal hemorrhage of any kind (Figure 1, Left panel). Of those positive for retinal hemorrhages, 42 (84%) had hemorrhages extending to the ora serrata, and 24 (48%) had a cherry hemorrhage. All 24 eyes (100%) with a cherry hemorrhage had hemorrhages extending to the ora serrata. Among the 42 eyes with hemorrhage extending to the ora, 18 (43%) did not have a cherry hemorrhage. Every abusive head trauma autopsy eye (100%) had at least 1 type of ocular hemorrhage (Figure 1, Middle panel).