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Abstract
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PURPOSE: To study orthograde axonal transport with amyloid precursor Protein (APP-A4) immunohistochemistry (IHC) in the retina and lamina cribrosa (LC) portion of the optic nerve in abusive head trauma (AHT) suspects.
DESIGN: Retrospective, case-control study.
METHODS: Seventy-two eyes from suspected AHT victims referred by the Los Angeles Coroner and control eyes from non-traumatized infants were included. IHC was conducted utilizing UCI Lab Medicine Department's standard protocol, included as an appendix, and results analyzed by light microcopy after paraffin processing. Quantitation of LC APP- A4 block was estimated in 21 cases with known survival utilizing MetaMorph, a proprietary biomicroscopy imaging software.
RESULTS: The presence or absence of APP-A4 label accumulations in retinal ganglion cells, nerve fiber layer at the disc margin, and in LC axonal bundles compared to matching tissues from non-traumatized control eyes with only background staining. Among the globes from AHT suspects with nerve heads available for study, 94% were positive for LC accumulation of marker. Among suspect AHT cases with known survival after injury, 1-1588 days, most demonstrated LC APP-A4 accumulations.
CONCLUSIONS: Our findings reinforce a recent publication demonstrating similar APP-A4 IHC LC orthograde axonal transport block in children with AHT and lead to a recommendation for intraocular pressures to be recorded and addressed in these patients.
Language: en |