Post-mortem ocular changes and time since death: Scoping review and future perspective |
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Affiliation: | 1. School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK;2. Ars Cogniscendi Centre for Forensic & Legal Medicine, Zuiderzeestraatweg 404, 8091 PB Wezep, The Netherlands;3. Department of Medical Biology, Section Anatomy, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;4. Faculty of Law, Maastricht University, Bouillonstraat 1-3, 6211 LH Maastricht, The Netherlands |
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Abstract: | The forensics literature on the relationship between ocular changes and the postmortem interval (PMI) has traditionally focused on time-related variations in concentrations of metabolites and elements within the eye. However, structural changes within the eye over time deserve the same attention because there is significant evidence of their importance in determining the time since death. Therefore, we reviewed publications that provided substantial evidence on this issue. In light of our inclusion and exclusion criteria, 26 papers were eligible for review. On the basis of the ocular parameters considered, we grouped the reviewed evidence into eight thematic areas: corneal opacities, corneal thickness, drug-induced pupil diameter variations, retinal changes, segmentation of retinal vessels, intraocular pressure reduction, globe temperature and crystalline alterations. The most important and common limitations of the reviewed studies were small study populations (many were monocentric studies), absence of robust statistical methodology, use of mathematical models valid only in ideal conditions and validation only for short PMIs. Although many phenomena cannot be used to reliably estimate PMI, there is rigorous evidence suggesting that promising factors, including corneal thickness, require methodological innovations for application to forensics practice but could be used in the near future to reliably estimate the time since death. |
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Keywords: | PMI Time since death Postmortem interval Postmortem eye changes Forensic science Postmortem investigation Autopsy |
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