Vitröz cisimciği olarak da bilinen göz içi sıvısı (GİS), %98-99'u su, protein, glikozaminoglikan, enzimler, metabolitler, hücreler, yağ asitleri ve elektrolitlerden oluşan jel formda bir sıvıdır. Bu biyolojik sıvı, postmortem araştırmalarda alternatif matriks olma özelliği taşımaktadır. Fiziksel, kimyasal ve biyolojik inertliği, otolize karşı dirençli olması, pütrifikasyon (çürüme) görülmemesi, postmortem yeniden dağılımın daha sınırlı olması, mikrobiyal üreme görülmemesi ve kontaminasyona karşı oldukça korunaklı olması, bu sıvıyı diğer postmortem biyolojik sıvılara göre avantajlı hâle getirmektedir. Bu nedenle postmortem evrede toplanması gereken ve antemortem dönem hakkında bilgi verebilecek değerli biyolojik materyaldir. GİS, adli bilimler alanına; postmortem ölüm zamanı tahmininde, ilaç/psikoaktif madde ve metabolit analizinde, antemortem alkol kullanımı (akut veya kronik) hakkında bilgi edinilmesinde, elektrolit bozuklukların tespitinde ve diyabetik ketoasidozun belirlenmesinde katkı sağlamaktadır. Özellikle ölüm esnasında herhangi bir şahidin bulunmadığı durumlarda ölüm nedenini ve zamanını belirleyebilir, olası şüpheli/şüphelileri dışlayabilir ve adli sürece katkılar sağlayabilir. Alternatif kullanım alanları üzerine hâlen sürdürülmekte olan araştırmalar son zamanlarda GİS'in, kişinin böbrek fonksiyonu hakkında da bilgi verebileceği üzerinde yoğunlaşmaktadır. Bu çalışmada, adli bilimler için önemli bir biyolojik örnek olan GİS'in, fiziksel ve kimyasal özelliklerinin, adli tıp ve adli toksikoloji alanlarındaki mevcut kullanımının, avantajlarının, kısıtlılıklarının ve potansiyel kullanım alanlarının ve analiz yöntemlerinin ele alınması amaçlanmıştır.
Anahtar Kelimeler: Göz içi sıvısı; postmortem; post-mortem interval; antemortem
Vitreous humor, also known as vitreous body, is a fluidlike gel, composed of approximately 98-99% water with protein, glycosaminoglycan, enzymes, metabolites, cells, fatty acids and electrolytes. This biological fluid has the feature of being an alternative matrix in post-mortem investigations. Physical, chemical and biological inertness, resisting to autolysis and putrefaction, limited postmortem redistribution, no microbial reproduction, and protecting itself from contaminations are some specific properties of the vitreous humor. This specimen having several ante-mortem information has many advantages than other post-mortem biological fluids. Applications of this biological sample in forensic sciences are post-mortem interval (PMI) estimation, determination of drug/psychoactive substances and their metabolites, ante-mortem alcohol consumption (acute or chronic), electrolyte imbalance assessment and diabetic ketoacidosis evaluation. Based on the analysis of vitreous humor, cause of death and PMI could be detected especially in the case of the absence of witness during death, therefore it may eliminate suspects, and contributes forensic investigation. Ongoing research on possible uses is focused on that vitreous humor may also provide information about the person's kidney function at the ante-mortem condition. This alternative biological sample is a promising fluid in post-mortem researches and other uses areas of this fluid is still searching. In this study, it was aimed to handle vitreous humor's chemical and physical structure, current uses, advantages and limitations of using this matrix in the forensic sciences and forensic toxicology, and analysis methods as a promising biological sample in the forensic field.
Keywords: Vitreous humor; post-mortem; post-mortem interval; ante-mortem
- Kalra J, Mulla A, Kopargaonkar A. Diagnostic value of vitreous humor in postmortem analysis. SM J Clin Pathol. 2016;1(1):1005.[Link]
- Baniak N, Campos-Baniak G, Mulla A, Kalra J. Vitreous humor: a short review on post-mortem applications. J Clin Exp Pathol 2015;5(1):1-7.[Link]
- Bévalot F, Cartiser N, Bottinelli C, Fanton L, Guitton J. Vitreous humor analysis for the detection of xenobiotics in forensic toxicology: a review. Forensic Toxicol. 2016;34:12-40.[Crossref] [PubMed] [PMC]
- Lappas NT, Lappas CM. Analytical samples. Forensic Toxicology: Principles and Concepts. 1st ed.Oxford: Elsevier; 2016. p.113-20.[Crossref]
- Mathur A, Agrawal YK. An overview of methods used for estimation of time since death. Australian Journal of Forensic Sciences. 2011;43(4):275-85.[Crossref]
- Kleinberg TT, Tzekov RT, Stein L, Ravi N, Kaushal S. Vitreous substitutes: a comprehensive review. Surv Ophthalmol. 2011;56(4):300-23.[Crossref] [PubMed]
- Pigaiani N, Bertaso A, De Palo EF, Bortolotti F, Tagliaro F. Vitreous humor endogenous compounds analysis for post-mortem forensic investigation. Forensic Sci Int. 2020;310:110235.[Crossref] [PubMed]
- Käsdorf BT, Arends F, Lieleg O. Diffusion regulation in the vitreous humor. Biophys J. 2015;109(10):2171-81.[Crossref] [PubMed] [PMC]
- Donati S, Caprani SM, Airaghi G, Vinciguerra R, Bartalena L, Testa F, et al. Vitreous substitutes: the present and the future. Biomed Res Int. 2014;2014:351804.[Crossref] [PubMed] [PMC]
- Gürler M, Altuntaş A. [Postmortem biochemistry]. Dicle Medical Journal. 2014;41(4):773-80.[Crossref]
- Dinis-Oliveira RJ, Vieira DN, Magalhães T. Guidelines for Collection of Biological Samples for Clinical and Forensic Toxicological Analysis. Forensic Sci Res. 2017;1(1):42-51.[Crossref] [PubMed] [PMC]
- Pelander A, Ristimaa J, Ojanperä I. Vitreous humor as an alternative matrix for comprehensive drug screening in postmortem toxicology by liquid chromatography-time-of-flight mass spectrometry. J Anal Toxicol. 2010;34(6):312-8.[Crossref] [PubMed]
- Baduroğlu E, Durak D. [The forensic medicine problems related with alcohol]. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2010;36(2):65-71.[Link]
- Kugelberg FC, Jones AW. Interpreting results of ethanol analysis in postmortem specimens: a review of the literature. Forensic Sci Int. 2007;165(1):10-29.[Crossref] [PubMed]
- Ioan BG, Jitaru V, Damian R, Damian SI. Study on the relationship between the concentration of ethanol in the blood, urine and the vitreous humour. Rom J Leg Med. 2015;23(3):211-6.[Crossref]
- Caplan YH, Levine B. Vitreous humor in the evaluation of postmortem blood ethanol concentrations. J Anal Toxicol. 1990;14(5):305-7.[Crossref] [PubMed]
- Li W, Chang Y, Cheng Z, Ling J, Han L, Li X, et al. Vitreous humor: a review of biochemical constituents in postmortem interval estimation. Journal of Forensic Science and Medicine 2018;4(2):85-90.[Link]
- Madea B, Henssge C, Hönig W, Gerbracht A. References for determining the time of death by potassium in vitreous humor. Forensic Sci Int. 1989;40(3):231-43.[Crossref] [PubMed]
- Murthy AS, Das S, Thazhath HK, Chaudhari VA, Adole PS. The effect of cold chamber temperature on the cadaver's electrolyte changes in vitreous humor and plasma. J Forensic Leg Med. 2019;62:87-91.[Crossref] [PubMed]
- Bray M. Chemical estimation of fresh water immersion intervals. Am J Forensic Med Pathol. 1985;6(2):133-9.[Crossref] [PubMed]
- Go A, Shim G, Park J, Hwang J, Nam M, Jeong H, et al. Analysis of hypoxanthine and lactic acid levels in vitreous humor for the estimation of post-mortem interval (PMI) using LC-MS/MS. Forensic Sci Int. 2019;299:135-41.[Crossref] [PubMed]
- Belsey SL, Flanagan RJ. Postmortem biochemistry: current applications. J Forensic Leg Med. 2016;41:49-57.[Crossref] [PubMed]
- Zilg B, Bernard S, Alkass K, Berg S, Druid H. A new model for the estimation of time of death from vitreous potassium levels corrected for age and temperature. Forensic Sci Int. 2015;254:158-66.[Crossref] [PubMed]
- Hanna PE, Bellamy JE, Donald A. Postmortem eyefluid analysis in dogs, cats and cattle as an estimate of antemortem serum chemistry profiles. Can J Vet Res. 1990;54(4):487-94.[PubMed] [PMC]
- Palmiere C, Mangin P. Urea nitrogen, creatinine, and uric acid levels in postmortem serum, vitreous humor, and pericardial fluid. Int J Legal Med. 2015;129(2):301-5.[Crossref] [PubMed]
- Patrick WJ, Logan RW. Free amino acid content of the vitreous humour in cot deaths. Arch Dis Child. 1988;63(6):660-2.[Crossref] [PubMed] [PMC]
- Ansari N, Menon SK. Determination of time since death using vitreous humor tryptophan. J Forensic Sci. 2017;62(5):1351-6.[Crossref] [PubMed]
- Lale A, Yıldırım MŞ, Akçan R, Balseven Odabaşı A, Tümer AR. [Postmortem interval estimation by vitreous fluid analysis from past to present]. J For Med. 2017;31(1):26-35.[Crossref]
- Odriozola A, Riancho JA, de la Vega R, Agudo G, García-Blanco A, de Cos E, et al. miRNA analysis in vitreous humor to determine the time of death: a proof-of-concept pilot study. Int J Legal Med. 2013;127(3):573-8.[Crossref] [PubMed]
- Ojänpera I, Ojansivu RL, Nokua J, Vuori E. Comprehensive TLC drug screening in forensic toxicology: comparison of findings in urine and liver. J Planar Chromatogr-Mod TLC. 1999;12(1):38-41.[Link]
- Busardò FP, Vaiano F, Mannocchi G, Bertol E, Zaami S, Marinelli E. Twelve months monitoring of hair GHB decay following a single dose administration in a case of facilitated sexual assault. Drug Test Anal. 2017;9(6):953-6.[Crossref] [PubMed]
- Busardò FP, Portelli F, Montana A, Rotolo MC, Pichini S, Maresi E. When a death apparently associated to sexual assault is instead a natural death due to idiopathic hypereosinophilic syndrome: The importance of gamma-hydroxybutyric acid analysis in vitreous humor. Leg Med (Tokyo). 2017;26:92-97.[Crossref] [PubMed]
- Pragst F, Spiegel K, Leuschner U, Hager A. Detection of 6-acetylmorphine in vitreous humor and cerebrospinal fluid--comparison with urinary analysis for proving heroin administration in opiate fatalities. J Anal Toxicol. 1999;23(3):168-72.[Crossref] [PubMed]
- Robertson MD, Drummer OH. Postmortem distribution and redistribution of nitrobenzodiazepines in man. J Forensic Sci. 1998;43(1):9-13.[Crossref] [PubMed]
- Scott KS, Oliver JS. The use of vitreous humor as an alternative to whole blood for the analysis of benzodiazepines. J Forensic Sci. 2001;46(3):694-7.[Crossref] [PubMed]
- Antonides HM, Kiely ER, Marinetti LJ. Vitreous fluid quantification of opiates, cocaine, and benzoylecgonine: comparison of calibration curves in both blood and vitreous matrices with corresponding concentrations in blood. J Anal Toxicol. 2007;31(8):469-76.[Crossref] [PubMed]
- Jenkins AJ, Oblock J. Phencyclidine and cannabinoids in vitreous humor. Leg Med (Tokyo). 2008;10(4):201-3.[Crossref] [PubMed]
- De Letter EA, De Paepe P, Clauwaert KM, Belpaire FM, Lambert WE, Van Bocxlaer JF, et al. Is vitreous humour useful for the interpretation of 3,4-methylenedioxymethamphetamine (MDMA) blood levels? Experimental approach with rabbits. Int J Legal Med. 2000;114(1-2):29-35.[Crossref] [PubMed]
- Holmgren P, Druid H, Holmgren A, Ahlner J. Stability of drugs in stored postmortem femoral blood and vitreous humor. J Forensic Sci. 2004;49(4):820-5.[Crossref] [PubMed]
- Chesser R, Pardi J, Concheiro M, Cooper G. Distribution of synthetic opioids in postmortem blood, vitreous humor and brain. Forensic Sci Int. 2019;305:109999.[Crossref] [PubMed]
- Palmiere C, Mangin P. Postmortem biochemical investigations in hypothermia fatalities. Int J Legal Med. 2013;127(2):267-76.[Crossref] [PubMed]
- Iten PX, Meier M. Beta-hydroxybutyric acid--an indicator for an alcoholic ketoacidosis as cause of death in deceased alcohol abusers. J Forensic Sci. 2000;45(3):624-32.[Crossref] [PubMed]
- Karlovsek MZ. Diagnostic values of combined glucose and lactate values in cerebrospinal fluid and vitreous humour--our experiences. Forensic Sci Int. 2004;146 Suppl:S19-23.[Crossref] [PubMed]
- Osuna E, García-Víllora A, Pérez-Cárceles M, Conejero J, Maria Abenza J, Martínez P, et al. Glucose and lactate in vitreous humor compared with the determination of fructosamine for the postmortem diagnosis of diabetes mellitus. Am J Forensic Med Pathol. 2001;22(3):244-9.[Crossref] [PubMed]
- Bray M, Luke JL, Blackbourne BD. Vitreous humor chemistry in deaths associated with rapid chilling and prolonged freshwater immersion. J Forensic Sci. 1983;28(3):588-93.[Crossref] [PubMed]
- Coe JI. Hypothermia: autopsy findings and vitreous glucose. J Forensic Sci. 1984;29(2):389-95.[Crossref] [PubMed]
- Fernández P, Seoane S, Vázquez C, Bermejo AM, Carro AM, Lorenzo RA. A rapid analytical method based on microwave-assisted extraction for the determination of drugs of abuse in vitreous humor. Anal Bioanal Chem. 2011;401(7):2177-86.[Crossref] [PubMed]
- Nielsen SS. Immunoassays. Food Analysis. 5th ed. West Lafayette: Springer; 2017. p.188,488.
- Metushi IG, Fitzgerald RL, McIntyre IM. Assessment and comparison of vitreous humor as an alternative matrix for forensic toxicology screening by GC-MS. J Anal Toxicol. 2016;40(4):243-7.[Crossref] [PubMed]
- Peres MD, Pelição FS, Caleffi B, De Martinis BS. Simultaneous quantification of cocaine, amphetamines, opiates and cannabinoids in vitreous humor. J Anal Toxicol. 2014;38(1):39-45.[Crossref] [PubMed]
- Cabarcos P, Tabernero MJ, Álvarez I, López P, Fernández P, Bermejo AM. Analysis of six benzodiazepines in vitreous humor by high-performance liquid chromatography-photodiode-array detection. J Anal Toxicol. 2010;34(9):539-42.[Crossref] [PubMed]
- Maurer HH. Liquid chromatography-mass spectrometry in forensic and clinical toxicology. J Chromatogr B Biomed Sci Appl. 1998;713(1):3-25.[Crossref] [PubMed]
- Thierauf A, Kempf J, Perdekamp MG, Auwärter V, Gnann H, Wohlfarth A, et al. Ethyl sulphate and ethyl glucuronide in vitreous humor as postmortem evidence marker for ethanol consumption prior to death. Forensic Sci Int. 2011;210(1-3):63-8.[Crossref] [PubMed]
- Fucci N, De Giovanni N, De Giorgio F, Liddi R, Chiarotti M. An evaluation of the Cozart RapiScan system as an on-site screening tool for drugs of abuse in a non-conventional biological matrix: vitreous humor. Forensic Sci Int. 2006;156(2-3):102-5.[Crossref] [PubMed]
- Ojanperä I, Vuori E, Nieminen R, Penttilä A. Screening for barbiturates in vitreous humor by the EMIT-st serum enzyme immunoassay. J Forensic Sci. 1986;31(2):707-9.[Crossref] [PubMed]
- Chronister CW, Gund AL, Goldberger BA. Rapid detection of opioids in vitreous humor by enzyme immunoassay. J Anal Toxicol. 2008;32(8):601-4.[Crossref] [PubMed]
- Mali N, Karpe M, Kadam V. A review on biological matrices and analytical methods used for determination of drug of abuse. Journal of Applied Pharmaceutical Science. 2011;1(6):58-65.[Link]
- Kapur BM. False positive drugs of abuse immunoassays. Clin Biochem. 2012;45(9):603-4.[Crossref] [PubMed]
- Datta P. Oxaprozin and 5-(p-hydroxyphenyl)-5-phenylhydantoin interference in phenytoin immunoassays. Clin Chem. 1997;43(8 Pt 1):1468-9.[Crossref] [PubMed]
- Grinstead GF. Ranitidine and high concentrations of phenylpropanolamine cross react in the EMIT monoclonal amphetamine/methamphetamine assay. Clin Chem. 1989;35(9):1998-9.[Crossref] [PubMed]
- Brahm NC, Yeager LL, Fox MD, Farmer KC, Palmer TA. Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm. 2010;67(16):1344-50.[Crossref] [PubMed]
- Randviir EP, Banks CE. Analytical methods for quantifying creatinine within biological media. Sensors and Actuators B: Chemical. 2013;183:239-52.[Crossref]
- Santos Júnior JC, Mollo Filho PC, Felice Guidugli RB, Eberlin MN, Pessôa Gde S, da Silva EG, et al. Metals and (metallo)proteins identification in vitreous humor focusing on post-mortem biochemistry. Metallomics. 2014;6(10):1801-7.[Crossref] [PubMed]
- Thierauf A, Musshoff F, Madea B. Post-mortem biochemical investigations of vitreous humor. Forensic Sci Int. 2009;192(1-3):78-82.[Crossref] [PubMed]
- Costa JL, Morrone AR, Resende RR, Chasin AA, Tavares MF. Development of a method for the analysis of drugs of abuse in vitreous humor by capillary electrophoresis with diode array detection (CE-DAD). J Chromatogr B Analyt Technol Biomed Life Sci. 2014;945-946:84-91.[Crossref] [PubMed]
- Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. JAMA. 2007;298(17):2038-47.[Crossref] [PubMed]
- Grams ME, Chow EK, Segev DL, Coresh J. Lifetime incidence of CKD stages 3-5 in the United States. Am J Kidney Dis. 2013;62(2):245-52.[Crossref] [PubMed] [PMC]
- Chawla LS, Eggers PW, Star RA, Kimmel PL. Acute kidney injury and chronic kidney disease as interconnected syndromes. N Engl J Med. 2014;371(1):58-66.[Crossref] [PubMed]
- Lentini P, Zanoli L, Granata A, Signorelli SS, Castellino P, Dell'Aquila R. Kidney and heavy metals - The role of environmental exposure (Review). Mol Med Rep. 2017;15(5):3413-9.[Crossref] [PubMed]
- Lea-Henry TN, Carland JE, Stocker SL, Sevastos J, Roberts DM. Clinical pharmacokinetics in kidney disease: fundamental principles. Clin J Am Soc Nephrol. 2018;13(7):1085-95.[Crossref] [PubMed] [PMC]
- Kim SY, Moon A. Drug-induced nephrotoxicity and its biomarkers. Biomol Ther (Seoul). 2012;20(3):268-72.[Crossref] [PubMed] [PMC]
- Sarwar A. Drugs in renal disease and pregnancy. Best Pract Res Clin Obstet Gynaecol. 2019;57:106-19.[Crossref] [PubMed]
- Maskell PD, Penney E, Smith PR, Hikin LJ, Morley SR. Post-mortem diagnosis of kidney impairment: An experimental study. Forensic Sci Int. 2019;301:271-7.[Crossref] [PubMed]
- Géhl Z, Bakondi E, Resch MD, Hegedűs C, Kovács K, Lakatos P, et al. Diabetes-induced oxidative stress in the vitreous humor. Redox Biol. 2016;9:100-3.[Crossref] [PubMed] [PMC]
- Kumagai A, Nakayashiki N, Aoki Y. Analysis of age-related carbonylation of human vitreous humor proteins as a tool for forensic diagnosis. Leg Med (Tokyo). 2007;9(4):175-80.[Crossref] [PubMed]
.: Process List