title: Morphologic analysis of artifacts in human fetal eyes confounding histopathologic investigations.
abstract: OBJECTIVE
  Human fetal eyes are an excellent source for studies of the normal ocular development and for examining early ocular changes associated with various syndromes in the context of a pediatric pathologic or prenatal sonographic diagnosis. However, artifacts caused by different factors often render an exact interpretation difficult. In this study, the frequency and extent of artifacts in human fetal eyes were investigated with the aim of distinguishing more precisely these artifacts from real findings, allowing also for a more diligent forensic interpretation.
  
  
  METHODS
  The cohort included 341 fetal eyes, ranging in age from 8 to 38 weeks of gestation, that were investigated macroscopically and by light microscopy.
  
  
  RESULTS
  In most specimens, artifacts such as pigment spillage and autolytic changes of the retina were noted. Nearly all specimens showed changes of the lens with remarkable similarities to cataractous lenses in adult eyes. Structural ocular changes associated with systemic syndromes were also observed and in most instances could be distinguished from artifacts.
  
  
  CONCLUSIONS
  Morphologic changes in fetal eyes should be classified in artifacts caused by way of abortion, mechanical effects from the removal of the eyes, delayed fixation with autolysis, and the fixative itself and should be distinguished from genuine structural abnormalities associated with ocular or systemic disease. This classification can be fairly difficult and requires experience. In addition, lens artifacts are often misleading, and the diagnosis of a fetal cataract should not be made based on histopathologic examination alone.
authors.affiliation: Department of Ophthalmology, Division of Ophthalmic Pathology, University of Bonn, Bonn, Germany. martina.herwig@ukb.uni-bonn.de
authors.forename: Martina C
authors.initials: MC
authors.lastname: Herwig
authors.forename: Annette M
authors.initials: AM
authors.lastname: Müller
authors.forename: Frank G
authors.initials: FG
authors.lastname: Holz
authors.forename: Karin U
authors.initials: KU
authors.lastname: Loeffler
mesh_terms: D016477:Artifacts; D005124:Eye Abnormalities / Q000175:diagnosis*; D005333:Fetus / Q000473:pathology*; D005865:Gestational Age; D006801:Humans