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Vol. 47. Issue 4.
Pages 150-156 (October - December 2021)
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Vol. 47. Issue 4.
Pages 150-156 (October - December 2021)
Original Article
Ocular tonometry in critically ill patients and their behaviour
Tonometría ocular en pacientes críticos y su comportamiento
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Sandra Vianney Ramirez Ojedaa,
Corresponding author
vianneyrmzojeda@gmail.com

Corresponding author.
, Martha Giselda Rangel Charqueñoa, Cesar Hernandez Mierb
a Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico
b Facultad de Derecho, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
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Figures (2)
Tables (4)
Table 1. Basal characteristics of the population studied.
Table 2. AM IOP and how it changes PM according to sex.
Table 3. AM IOP and how it changes PM according to cause of death.
Table 4. AM IOP and how it changes PM according to time of death.
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Abstract
Introduction

The study of the post-mortem interval is an important element in the investigation of criminal acts. It is also one of the most difficult variables to quantify and establish. Various cadaveric phenomena are used to assess it, some of which are ocular, such as intraocular pressure. There are currently no reliable indicators of its behaviour over time.

Material and methods

Prospective, longitudinal, descriptive, and analytical study. Ante-mortem and post-mortem intraocular pressure was measured in seriously ill patients with progression to death, performing descriptive analysis of variables and application of the student’s t test, χ2 and ANOVA.

Results

Ninety-five eyes were studied, obtaining a mean ante-mortem intraocular pressure of 13.4mmHg, which progressively decreased during the four hours post-mortem, 10.4mmHg per hour, 8.48mmHg at 2h, 6.17mmHg at 3h, and 3.81mmHg at 4h. In the repeated measures ANOVA test, a clinically significant value of P<.001 was obtained.

Conclusions

In this study, an inverse relationship was observed between post-mortem intraocular pressure and post-mortem interval, with a linear decrease over time of 2mmHg per hour. Therefore, the measurement of intraocular pressure is a fast and reproducible method, which can be used as an additional element to estimate the post- mortem interval.

Keywords:
Post-mortem interval
Tonometry
Intraocular pressure
Resumen
Introducción

El estudio del intervalo post mortem es un elemento importante en la investigación de hechos delictivos, además, es una de las variables más difíciles de cuantificar y establecer. Para su valoración, se utilizan diversos fenómenos cadavéricos, algunos de ellos oculares, como la presión intraocular, sin existir actualmente indicadores confiables de su comportamiento a través del tiempo.

Material y métodos

Estudio prospectivo, longitudinal, descriptivo y analítico. Se midió la presión intraocular ante mortem y post mortem de pacientes gravemente enfermos con evolución a muerte, realizándose análisis descriptivo de variables y aplicación de las pruebas t de Student, χ2 y ANOVA.

Resultados

Se analizaron 95 ojos, obteniendo una presión intraocular media ante mortem de 13,4mmHg, la cual disminuyó progresivamente durante las 4horas de seguimiento post mortem: la presión intraocular media fue de 12,3mmHg a la hora cero post mortem, 10,4mmHg a la hora, 8,48mmHg a las 2horas, 6,17mmHg a las 3horas y 3,81mmHg a las 4horas. En la prueba de ANOVA de medidas repetidas se obtuvo un valor clínicamente significativo de p<0,001.

Conclusiones

En este estudió se observó una relación inversa entre la presión intraocular post mortem y el intervalo postmortem, con una disminución lineal con el tiempo de 2mmHg por hora, por lo que la medición de la presión intraocular es un método rápido y reproducible, que puede ser utilizado como elemento adicional para estimar el intervalo.

Palabras clave:
Intervalo post mortem
Tonometría
Presión intraocular

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