Tonometría ocular en pacientes críticos y su comportamiento / Ocular tonometry in critically ill patients and their behaviour

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 estudio se observó una relación inversa entre la presión intraocular post mortem y el intervalo post mortem, 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. (AU)

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 2hours, 6.17mmHg at 3hours, and 3.81mmHg at 4hours. 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. (AU)

Analysis of the p53 pathway in peripheral blood of retinoblastoma patients; potential biomarkers.

Loss of retinoblastoma (RB) function in the cone cells during retina development is necessary but not sufficient for retinoblastoma development. It has been reported that in the absence of RB activity, a retinoma is generated, and the onset of retina cancer occurs until the p53 pathway is altered. Unlike other types of cancer, in retinoblastoma the p53 tumour suppressor is mostly wild type, although its two primary regulators, MDMX and MDM2, are commonly dysregulated. A mutated RB form is inherited in around 35% of the cases, but normally two, somatic mutations are needed to alter the RB function. Here we investigated the mRNA levels of RB, p53, MDMX and MDM2 in peripheral blood samples of retinoblastoma patients to monitor the pathway status of p53 in somatic cells. We sought to investigate the involvement of these genes in the development of retina cancer, with the aim of identifying biomarkers for early diagnosis of this disease.