Amyloid Precursor Protein in Abusive Head Trauma Suspects

Don S Minckler; Donald J Brown; Angele Nalbandian; Donny W Suh

doi:10.1016/j.ajo.2022.02.018

Amyloid Precursor Protein in Abusive Head Trauma Suspects

Am J Ophthalmol. 2022 Aug:240:58-66. doi: 10.1016/j.ajo.2022.02.018. Epub 2022 Mar 2.

Authors

Don S Minckler¹, Donald J Brown², Angele Nalbandian², Donny W Suh²

Affiliations

¹ From the Gavin Herbert Eye Institute, Department of Ophthalmology (D.S.M., D.J.B., A.N., D.W.S.), USA; Department of Laboratory Medicine (Ocular Pathology), University of California, Irvine, California, (D.S.M.), USA. Electronic address: minckler@hs.uci.edu.
² From the Gavin Herbert Eye Institute, Department of Ophthalmology (D.S.M., D.J.B., A.N., D.W.S.), USA; Department of Laboratory Medicine (Ocular Pathology), University of California, Irvine, California, (D.S.M.), USA.

PMID: 35247337
DOI: 10.1016/j.ajo.2022.02.018

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.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Amyloid beta-Protein Precursor* / metabolism
Case-Control Studies
Child
Child Abuse* / diagnosis
Craniocerebral Trauma* / diagnosis
Humans
Infant
Retinal Ganglion Cells
Retrospective Studies

Substances

Amyloid beta-Protein Precursor