Examination of postmortem retinal folds: A non-invasive study
Examination of postmortem retinal folds: A non-invasive study
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死后视网膜皱襞检查：一项非侵入性研究
DOI：
10.1016/j.jflm.2014.12.011
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发表时间：
2015
影响因子：
1.5
通讯作者：
Sohtaro Mimasaka
中科院分区：
文献类型：
--
作者：
Toru Oshima;Hiroshi Yoshikawa;Maki Ohtani;Sohtaro Mimasaka
死后视网膜褶皱先前有文献记载，但其形成机制尚不清楚。所有先前的折叠研究涉及侵入性技术和死后的眼底尚未进行非侵入性检查。本研究采用非侵入性单眼间接检眼镜和眼超声检查技术对42具尸体的79只死后眼睛进行了检查。我们研究了死后视网膜褶皱是否与死后时间、位置和/或年龄有关。年龄与死后视网膜褶皱形成显著相关（mann - whitneytest, P = 0.013），这促使我们研究玻璃体后脱离（PVD）对视网膜褶皱的影响。PVD的缺失与视网膜褶皱的存在在统计学上相关（Fisher精确检验，P < 0.0001）。有趣的是，PVD的存在也与视网膜褶皱高度显著相关（mann - whitney test, P < 0.0001）。因此，我们假设视网膜褶皱是由死后眼球松弛引起的玻璃体视网膜牵拉引起的。我们也认为视网膜脉络膜静水压力的丧失起了一定的作用。重要的是，法医病理学家不要混淆死后视网膜褶皱与创伤性视网膜脱离或黄斑周围视网膜褶皱引起的虐待儿童。当怀疑虐待儿童时，法医病理学家应进行去核和随后的组织学检查以确认。
The postmortem retinal fold has been previously documented, but its mechanism of formation is not known. All previous studies of the fold involved invasive techniques and the postmortem ocular fundus has yet to be non-invasively examined. Our study used the non-invasive techniques of monocular indirect ophthalmoscopy and ocular echography to examine 79 postmortem eyes of 42 bodies. We examined whether the postmortem retinal fold was associated with postmortem time, position, and/or age.Age was significantly associated with postmortem retinal fold formation (Mann–WhitneyUtest, P = 0.013), which led us to examine the effect of posterior vitreous detachment (PVD) on retinal folds. The absence of a PVD was statistically associated with the presence of a retinal fold (Fisher's exact test, P < 0.0001). Interestingly, the presence of a PVD was also significantly correlated with retinal fold height (Mann–WhitneyUtest, P < 0.0001). Therefore, we hypothesized that retinal folds result from postmortem vitreoretinal traction caused by eyeball flaccidity. We also believe that the loss of retinochoroidal hydrostatic pressure plays a role.It is important that forensic pathologists not confuse a postmortem retinal fold with traumatic retinal detachment or perimacular retinal folds caused by child abuse. When child abuse is suspected, forensic pathologists should perform enucleation and a subsequent histological examination for confirmation.