Amyloid Precursor Protein in Abusive Head Trauma Suspects.
Minckler Don S, Brown Donald J, Nalbandian Angele, Suh Donny W
AI Summary
This study found significant axonal transport block in the optic nerve's lamina cribrosa in 94% of abusive head trauma cases, suggesting intraocular pressure assessment is crucial in these patients.
Abstract
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 nontraumatized infants were included. IHC was conducted using University of California, Irvine (UCI), Lab Medicine Department's standard protocol and results analyzed by light microcopy after paraffin processing. Quantitation of LC APP-A4 block was estimated in 21 cases with known survival using 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 were compared to matching tissues from nontraumatized 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 of 1 to 1588 days, most demonstrated LC APP-A4 accumulations.
Conclusions
Our findings reinforce a recent publication based on APP-A4 IHC that demonstrated similar orthograde axonal transport block in the LC in children with AHT and recommend that intraocular pressures be recorded and addressed in these patients.
MeSH Terms
Shields Classification
Key Concepts5
Among globes from abusive head trauma (AHT) suspects with nerve heads available for study, 94% were positive for lamina cribrosa (LC) accumulation of amyloid precursor protein (APP-A4) marker.
Among suspect abusive head trauma (AHT) cases with known survival after injury of 1 to 1588 days, most demonstrated lamina cribrosa (LC) amyloid precursor protein (APP-A4) accumulations.
The findings reinforce a recent publication based on amyloid precursor protein (APP-A4) immunohistochemistry (IHC) that demonstrated similar orthograde axonal transport block in the lamina cribrosa (LC) in children with abusive head trauma (AHT).
The presence of amyloid precursor protein (APP-A4) label accumulations in retinal ganglion cells, nerve fiber layer at the disc margin, and in lamina cribrosa (LC) axonal bundles was compared to matching tissues from nontraumatized control eyes with only background staining in a retrospective case-control study.
It is recommended that intraocular pressures be recorded and addressed in children with abusive head trauma (AHT).
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