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死后角膜变化的形态学分析:动物模型的 OCT 初步研究。

Morphological analysis of corneal findings modifications after death: A preliminary OCT study on an animal model.

机构信息

Department of Medical Sciences and Public Health, Forensic Science Unit, University of Cagliari, Cagliari, Italy.

Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy.

出版信息

Exp Eye Res. 2018 Apr;169:20-27. doi: 10.1016/j.exer.2018.01.013. Epub 2018 Jan 31.

Abstract

The aim of this work was to describe, for the first time, the morphological modifications, in a three-dimensional mode, of the central cornea at different intervals since death. The study design involved the analysis of 30 eyes (15 heads) of female, adult sheep (>2 years) sacrificed at a local slaughterhouse. The eyes, after animal decapitation, were examined in situ, without enucleation. Ocular globes were stored at well-known temperature (within a range of 12-22 °C) and humidity (within a range of 50-60%). The instrumental analysis was executed using a portable spectral-domain OCT (SD-OCT) system (iVue SD-OCT, Optovue Inc, Fremont, CA) calibrated to the corneal mode. OCT imaging was performed at different time-points since death. Pachymetric map, morphological and ultrastructural analysis (epithelium, stroma, and endothelium), were performed for each time-point. After an initial thinning of tissues and an enhancement of epithelial reflectivity, stromal thickness increased from the 2nd up to the 6th hour. Subsequently, a new trend incorneal thinning was observed in association with the appearance ofone or more demarcation lines between the anterior andposterior stroma. After the 12th hour, a recurrence of corneal swelling was detected in association with thedelamination of stromal tissue. Since the 24th hour, the epithelium disappeared in 50% of cases and the anterior chamberdepth progressively decreased. At the 48th hour, various ocular structures showed the onset of putrefaction processes, such as theappearance of hyper-reflective dots in anterior chamber, iridocorneal contact, and the massive vacuolization of theposterior stroma until the total delamination. The portable OCT system is a useful approach for in situ postmortem corneal examination, and it may be potentially applied for the selection of donor cornea in transplantology and for the determination of post-mortem intervals in forensic medicine.

摘要

本研究首次以三维模式描述了死后不同时间间隔中央角膜的形态学变化。该研究设计包括对 30 只(15 个头)成年雌性绵羊(>2 岁)的眼睛进行分析,这些绵羊均来自当地屠宰场。在动物斩首后,眼球在不进行眼球摘除的情况下进行原位检查。眼球在已知温度(12-22°C 范围内)和湿度(50-60%范围内)下储存。仪器分析使用便携式谱域 OCT(SD-OCT)系统(iVue SD-OCT,Optovue Inc,加利福尼亚州弗里蒙特)在角膜模式下进行校准。在死后不同时间点进行 OCT 成像。在每个时间点进行角膜厚度图、形态和超微结构分析(上皮、基质和内皮)。组织初始变薄和上皮反射性增强后,基质厚度从第 2 小时增加到第 6 小时。随后,在前基质和后基质之间出现一条或多条分界线,角膜再次变平。第 12 小时后,发现角膜肿胀再次发生,与基质组织分层有关。从第 24 小时起,50%的病例上皮消失,前房深度逐渐减小。第 48 小时时,各种眼部结构开始出现腐败过程,如前房出现高反射点、虹膜角膜接触和后基质大量空泡化,直至完全分层。便携式 OCT 系统是一种用于死后角膜原位检查的有用方法,它可能潜在地应用于移植学中供体角膜的选择和法医学中死后时间间隔的确定。

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