Postmortem İnterval Tayininde Göz ve Göz içi Sıvıların Kullanımı

Yıl 2024, Cilt: 17 Sayı: 3, 183 - 188, 30.12.2024

Burak Kaya

https://doi.org/10.52976/vansaglik.1483358

Öz

Problemin Tanımı: Ölümün meydana gelmesi ile ölü muayenesi arasında geçen süre postmortem interval (PMI) olarak tanımlanmakta olup adli tıp pratiğinde cevaplanması gereken önemli sorulardan biridir. PMI tayininde temel olarak ölüm sonrası gelişen ölü lekeleri, ölü sertliği, ölü soğuması gibi değişimlerden faydalanılmakta olup bu bulgulara göre PMI hakkında sınırlı bir bilgi edinilmektedir. Göz ve göz içi sıvısı da PMI tayininde sıklıkla incelenen vücut bölümlerinden biridir.
Amaç: Çalışmamızda adli tıp alanında açıklanması gereken önemli konulardan olan PMI tayininde göz ve göz içi sıvısının kullanımı ile ilgili yapılmış çalışmalar güncel literatür ışığında incelenerek adli bakış açısı kazanılması amaçlanmıştır.
Teorik Çerçeve: Yapılan çalışmalarda korneadaki opasite, kalınlık ve endotel hücre yoğunluğundaki değişiminin PMI ile korele olduğu fakat ortam koşulları, yaş, göz kapaklarının kapalı olup olmaması ve standardizasyon eksikliği gibi faktörlerden etkilendiği görülmüştür. Göz içi sıvısındaki elektrolitlerden potasyumun PMI tayininde en güvenilir yöntem olduğu, fakat PMI tayininde diğer yöntemlerle birlikte değerlendirilmesi gerektiği vurgulanmıştır. Aminoasitlerde ise sadece triptofan seviyesinin PMI ile ilişkili olduğu bildirilmiştir.
Sonuç: PMI tayininde günümüz bilimsel verileri ışığında birçok yöntem araştırılmış, göz ve göz içi sıvısı da bu konuda sıklıkla araştırma konusu olmuştur. Göz ve göz içi sıvısında birçok çalışma yapılmış olmakla birlikte istenen düzeyde sonuçlar alınamadığı görülmüştür. Ölüm nedeni, ölümün gerçekleştiği mevsim ve hava koşulları, ortam sıcaklığı, ölenin yaşı, var olan hastalıklar, göz içi cerrahi operasyonlar, vücut yapısı, metabolik durum, göz kapaklarının kapalı olup olmaması gibi birçok farklılık bu durumu etkilemektedir. PMI tayininde sadece bir yöntemi uygulamak yerine birden fazla yöntemin birlikte uygulanmasının daha doğru sonuçlar vereceği düşünülmektedir.

Anahtar Kelimeler

Ölüm Zamanı, Postmortem İnterval, Göz, Göz İçi Sıvısı.

USE OF THE EYE AND VİTREOUS FLUID IN POSTMORTEM INTERVAL ESTIMATION: A REVIEW

Öz

Problem Description: The time between death and examination is defined as postmortem interval (PMI) and is one of the important questions that need to be answered in forensic medicine practice. In estimating the PMI, changes such as livor mortis, rigor mortis, and algor mortis are mainly used, and limited information about PMI is obtained according to these findings. The eye and vitreous fluid are also one of the body parts frequently examined in PMI estimation.
Aim: In our study, it was aimed to gain a forensic perspective by examining the studies on the use of the eye and vitreous fluid in PMI estimation, which is one of the important issues that need to be explained in the field of forensic medicine, in the light of the current literature.
Theoretical Framework: Studies have shown that the change in corneal opacity, thickness and endothelial cell density is correlated with PMI, but is affected by factors such as environmental conditions, age, whether the eyelids are closed or not, and lack of standardization. It has been emphasized that potassium, among the electrolytes in the vitreous fluid, is the most reliable method in estimating PMI, but it should be evaluated together with other methods in estimating PMI. Among amino acids, it has been reported that only tryptophan level is associated with PMI.
Conclusion: Many methods have been researched in PMI estimation in the light of today's scientific data, and the eye and vitreous fluid have also been the subject of frequent research on this subject. Although many studies have been conducted on the eye and vitreous fluid, it seems that the desired results cannot be obtained. Many differences such as the cause of death, the season and weather conditions in which death occurred, ambient temperature, the age of the deceased, existing diseases, intraocular surgical operations, body structure, metabolic status, and whether the eyelids are closed or not, affect this situation. It is thought that applying more than one method together instead of applying only one method in PMI estimation will give more accurate results.

Anahtar Kelimeler

Death Time, Postmortem Interval, Eye, Vitreous Fluid

Kaynakça

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