受虐待致死儿童的眼内改变

作者收集了美国洛杉矶市1984年4月至1987年2月受虐待致死儿童案例39例,非虐待致死对照73例。摘取双侧眼球在美国南加里福尼亚大学医学院眼科病理室进行组织病理学检查。在受虐待致死儿童中,发生眼内改变者约占64%。其眼内改变主要是视网膜各层的出血,玻璃体的出血,视网膜剥离,视神经乳头水肿或出血,视神经鞘内的出血和晶体的外伤性白内障。对照案例中,眼内有改变者约占28%。其改变主要为视网膜及其它眼内出血,视神经乳头水肿等,并多见于交通事故及其它易于引起头部外伤的意外。将受虐待致死小儿眼内改变与尸体解剖所见联系起来考虑,引起眼内改变的机理最重要的是头部的外伤及挥鞭样综合征。

THE INTRAOCULAR CHANGES IN FATALLY ABUSED CHILDREN

39 cases of fatally abused children were collected during April,1984 to febraury,1987 in Los Angeless,U.S.A.73 cases of non-abused children were obtained as control.Both eyes of each case were taken and examined histo- pathologically.The intraocular changes occured in 64% of the fatally abused children.They were:Retinal hemorrhage,vitrous hemorrhage,retinal de- tachmedt,papilledema,subdural hemorrhage of the optic nerve and traum- atic cataract.On the other hand,the intraocular changes occured in 28% of control cass,especially in those of traffic and other accidents which usually caused the injuries of head and neck.Considering the intraocular changes and the general injuries together,we suggest that the most important mec- hanism of the intraocular changes be head injuries and whiplash syndrome.